Medical Billing Software Medical Insurance Billing 5

Question 1

What does 'accounts receivable (AR) aging' track in a medical billing software system?

Accepted Answer

Outstanding claim balances categorized by how long they have been unpaid

Answer

AR aging reports categorize unpaid claims into time buckets (e.g., 0–30, 31–60, 61–90 days) to help practices identify and prioritize collection efforts.

Question 2

Which federal law established requirements for electronic transmission of health information and privacy protections in medical billing?

Accepted Answer

Health Insurance Portability and Accountability Act (HIPAA)

Answer

HIPAA established national standards for electronic healthcare transactions and set privacy and security requirements for protected health information (PHI).

Question 3

In medical billing, what is a 'dirty claim'?

Accepted Answer

A claim that contains errors or missing information that prevents automatic processing

Answer

A dirty claim contains errors such as incorrect patient demographics, missing codes, or invalid information that cause the payer to reject or suspend it rather than process it automatically.

Question 4

What is the significance of the 'taxonomy code' on a medical claim?

Accepted Answer

It specifies the provider's specialty or type of practice for accurate claim routing and payment

Answer

The taxonomy code is a 10-character alphanumeric code that describes a provider's type, classification, and specialty, used by payers to route claims and apply correct reimbursement rules.

Question 5

Under Medicare's fee schedule, what does the term 'non-participating provider' mean?

Accepted Answer

A provider who has not signed a participation agreement with Medicare and may collect only up to the limiting charge

Answer

Non-participating providers have not agreed to accept Medicare's approved amount as full payment, so they may bill patients up to 115% of the non-par fee schedule (the limiting charge).

Medical Billing Software Practice Test

Medical Billing Software Practice Test

Medical Billing Software Medical Insurance Billing 5