CEHRS Revenue Cycle and Billing 3

Question 1

Which claim form is used to bill outpatient and professional services to Medicare?

Accepted Answer

CMS-1500

Answer

The CMS-1500 (also called HCFA-1500) is used by physicians and other non-institutional providers to bill Medicare and most other payers.

Question 2

A provider writes off the difference between billed charges and the insurance-allowed amount. This is called a:

Accepted Answer

Contractual adjustment

Answer

A contractual adjustment reflects the difference between a provider's billed charges and the contracted allowed amount, which cannot be billed to the patient.

Question 3

The National Provider Identifier (NPI) is a:

Accepted Answer

10-digit numeric identifier assigned to healthcare providers

Answer

The NPI is a standard, unique 10-digit identification number issued by CMS to covered healthcare providers under HIPAA.

Question 4

Which modifier is appended to a CPT code to indicate that a procedure was performed bilaterally?

Accepted Answer

-50

Answer

Modifier -50 indicates that a procedure was performed bilaterally (on both sides of the body) during the same operative session.

Question 5

The term 'clean claim' refers to a claim that:

Accepted Answer

Contains all required information and no errors requiring follow-up

Answer

A clean claim is one that is complete, accurate, and can be processed and paid without additional information or correction.

(CEHRS) Certified Electronic Health Records Specialist Practice Test

(CEHRS) Certified Electronic Health Records Specialist Practice Test

CEHRS Revenue Cycle and Billing 3