Free RHIT Questions and Answers 1

Question 1

The Medicare Outpatient Code Editor (OCE) carries out the coding, coverage, clinical, and adjustments listed below.

Accepted Answer

claims.

Answer

The following types of modifications are carried out by the Medicare Outpatient Code Editor (OCE):
Coding: Verifies that the claim does not involve just inpatient operations, that the codes are correct, and that there are no disputes based on age or gender.
Guarantees that claims are for procedures that are covered.
Clinical: Assures the accuracy of the demographic data.
Claims: Assures accuracy of dates, units of service, and observations.

Question 2

How soon after a claim denial from an insurance like Blue Cross/Blue Shield must an internal appeal be filed?

Accepted Answer

180

Answer

If an insurer, such as Blue Cross/Blue Shield, rejects a claim, the insurance company must file an internal appeal within 180 days following the rejection. For services to be provided in the future, the insurance provider must finish the appeals process and make a determination within 30 days, and for services previously rendered, within 60 days. The claimant has 60 days following notification of the denial to obtain an external review by a third party if the insurer continues to decline the claim.

Question 3

Which of the following is an illustration of malware that spreads throughout a system by duplicating itself?

Accepted Answer

Computer worm

Answer

A computer worm is a software that may propagate throughout a system by duplicating itself rather than attaching to another program. A computer virus is a software that copies itself, affixes to another program, and then spreads to alter data. A Trojan horse enables illegal access to a computer so that information can be obtained or emails can be sent. A rootkit is a piece of software that has access to an operating system on a computer and changes it.

Question 4

The real cost of a visit to a doctor for a patient who receives care from a non-participating Medicare provider who rejects assignment is $300. The patient has no additional insurance, and the usual, customary, and reasonable (UCR) price is $240.00. How much of the patient's expenses will be out-of-pocket?

Accepted Answer

$117.60

Answer

The patient will have to pay $117.60 out of pocket. Medicare typically pays $192 for the appointment because it only covers 80% of the UCR bill ($240.80). However, the doctor only receives 95% of the standard payment ($192.95) or $182.40 ($300 - $182.40 = $117.60) because they are not participating and have not accepted assignment.

Question 5

Which of the following is the greatest option for a healthcare institution looking for a classification system to quantify levels of functional ability and disability?

Accepted Answer

ICF

Answer

ICF (International Classification of Functioning, Disability, and Health) is the best alternative for a healthcare organization looking for a classification system to measure degrees of functioning, disability, and health. The ICF is divided into 4 code components:
Part I: Body Structure and Body Function: Functioning and Disability.
Part II: Environmental factors, activities, and participation within the context.
Impairment is rated on a scale of 0 to 4, with a code 8 denoting ""not specified"" and a 9 denoting ""not applicable.""

RHIT - Registered Health Information Technician Practice Test

RHIT - Registered Health Information Technician Practice Test

Free RHIT Questions and Answers 1