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| Section | Objectives |
|---|---|
| Medical Billing Fundamentals | - Insurance types and payer structures - Healthcare reimbursement systems - Medical billing workflow and revenue cycle |
| Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Private insurance policies and contracts - Medicare and Medicaid guidelines |
| Compliance and Regulations | - Fraud and abuse prevention - HIPAA and patient privacy rules - Billing compliance standards |
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview |
| Revenue Cycle Management | - Payment posting and reconciliation - Claims denial and rejection management - Accounts receivable follow-up |
Question 1
The medical prefix "hyper-" means:
A. condition
B. uterus, womb
C. above, excessive
Question 2
American Academy of Processional Coders (AAPC) is professional association established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to network, and to increase and promote national recognition and awareness of professional coding.
A. FALSE
B. TRUE
Question 3
EQRO
A. External Quality Review Organization
B. First Look Analysis for Hospital Outlier Monitoring
C. Employee Retirements income security Act of 1974
D. Electronic Remittance Advice
Question 4
The word root "hema" refers to:
A. half
B. liver
C. blood
Question 5
Ambulance Fee Schedule is payment system for ambulance services provided to Medicare Beneficiaries.
A. FALSE
B. TRUE
Solutions:
| Question 1 Answer: C | Question 2 Answer: B | Question 3 Answer: A | Question 4 Answer: C | Question 5 Answer: B |
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