CMAA Billing, Coding, and Claims 3

Question 1

What is Medicare's timely filing limit for initial claim submission?

Accepted Answer

365 days

Answer

Medicare requires initial claims within 365 days from the date of service. Late submissions are typically denied permanently.

Question 2

Which modifier indicates a procedure was performed bilaterally?

Accepted Answer

Modifier -50

Answer

Modifier -50 indicates bilateral procedures. Many payers pay 150% of the unilateral rate.

Question 3

What action should be taken when a claim is rejected at the clearinghouse level?

Accepted Answer

Correct the errors and resubmit

Answer

Clearinghouse rejections indicate data errors that prevented the claim from reaching the payer. Fix the errors and resubmit.

Question 4

In the revenue cycle, what does 'accounts receivable' refer to?

Accepted Answer

Money owed to the practice for services rendered

Answer

Accounts receivable represents outstanding payments owed to the practice from insurance and patients for services already provided.

Question 5

What is coordination of benefits (COB)?

Accepted Answer

Determining payment order when a patient has multiple insurance plans

Answer

COB determines which plan pays first (primary) and second (secondary) when a patient has multiple insurance plans.

CMAA - Certified Medical Administrative Assistant Practice Test