Financial Processes Flashcards
6 cards from real CHAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Financial Processes flashcards as text
A patient's insurance plan has a $2,000 deductible and they have met $1,500. What should the access associate communicate about a $800 procedure?
Answer: The patient may owe approximately $500 toward the deductible plus any applicable coinsurance
With $500 remaining on the deductible, the patient would owe that amount plus any coinsurance on the remaining $300, depending on plan terms.
What is the primary purpose of collecting point-of-service (POS) payments?
Answer: To reduce accounts receivable days and improve cash flow
POS collections reduce the accounts receivable cycle, improve cash flow, and decrease the cost of post-service collection efforts.
A patient qualifies for charity care but also has Medicaid. How should this be handled?
Answer: Bill Medicaid first as the primary payer, then apply charity care to remaining balance if applicable
Insurance must always be billed as the primary payer before applying charity care or financial assistance to any remaining patient responsibility.
What does 'timely filing' refer to in the context of healthcare billing?
Answer: Submitting insurance claims within the payer's deadline to avoid denial
Timely filing refers to the deadline by which claims must be submitted to an insurance payer, typically ranging from 90 days to one year depending on the payer.
Which document is required before providing a patient with a good faith estimate under the No Surprises Act?
Answer: A scheduled service or a patient request for an estimate
Under the No Surprises Act, facilities must provide good faith estimates to uninsured or self-pay patients upon scheduling or upon request.
What is a 'clean claim' in healthcare billing?
Answer: A claim submitted with all required data elements and no errors
A clean claim contains all required fields, correct codes, and accurate patient/insurance information, allowing processing without additional development.