Get Answer: Follow Effort Made Question Guide

Students often encounter this when studying fundamental concepts.

What This Question Is About

This question relates to follow effort made and requires a structured academic response.

How to Approach This Question

Structure your response with introduction, analysis, and conclusion.

Key Explanation

This topic involves follow effort made. A strong answer should include explanation, application, and examples.

Original Question

A follow-up effort made to an insurance company to locate the status of an insurance claim is called a/an Select one: a. inquiry. b. tracer. c. rebill. d. inquiry and tracer. Clear my choice Question 2 Not yet answered Points out of 1.00 Flag question Question text Which of the following is NOT an advantage of using a clearinghouse? Select one: a. Reduction in time of claims preparation b. Fewer claim rejections c. No need for trained staff to code claims prior to submission d. Consistent reimbursement Clear my choice Question 3 Not yet answered Points out of 1.00 Flag question Question text Data that is made unintelligible to unauthorized parties is referred to as Select one: a. coded. b. decoded. c. encoded. d. encrypted. Clear my choice Question 4 Not yet answered Points out of 1.00 Flag question Question text The maximum dollar value that the insurance company assigns to each medical service is referred to as Select one: a. charge. b. allowed amount. c. adjustment amount. d. paid amount. Clear my choice Question 5 Not yet answered Points out of 1.00 Flag question Question text In 2023, the minimum dollar amount for judicial review of a Medicare claim in federal district court which must be met is $1500. Select one: a. True b. False Clear my choice Question 6 Not yet answered Points out of 1.00 Flag question Question text Under HIPAA, health care providers must submit electronic claims if: Select one: a. they have fewer than 10 employees b. they have more than 10 employees c. they have more than 10 providers d. they have more than 10 locations where they provider services Clear my choice Question 7 Not yet answered Points out of 1.00 Flag question Question text Expedited TRICARE appeals must be filed within 3 days of the receipt of the initial denial. Select one: a. True b. False Clear my choice Question 8 Not yet answered Points out of 1.00 Flag question Question text A listing of outstanding accounts that have not been paid is referred to as Select one: a. A claims submission report. b. A backlog report. c. A purge report. d. An aging report. e. A rebill report. Clear my choice Question 9 Not yet answered Points out of 1.00 Flag question Question text Insurance companies are regulated by a federal regulatory agency. Select one: a. True b. False Clear my choice Question 10 Not yet answered Points out of 1.00 Flag question Question text Federal legislation enacted to require providers to submit claims electronically. Select one: a. Medicare Integrity Program b. HIPAA Transaction and Code Sets rule c. Patient Protection and Affordable Care Act d. Administrative Simplification Compliance Act Clear my choice Question 11 Not yet answered Points out of 1.00 Flag question Question text The document together with the payment voucher that is sent to a physician who has accepted assignment of benefits is referred to as an Select one: a. EOB. b. EOMB. c. MRA. d. MPS. Clear my choice Question 12 Not yet answered Points out of 1.00 Flag question Question text Only unorganized and poorly managed healthcare organizations will experience claim denials. Select one: a. True b. False Clear my choice Question 13 Not yet answered Points out of 1.00 Flag question Question text Guidelines for claims submission, such as which services are covered, and reimbursement rates is dictated by: Select one: a. the insurance company b. the healthcare provider c. the insured d. the insured’s employer Clear my choice Question 14 Not yet answered Points out of 1.00 Flag question Question text If the insurance billing specialist posts a payment and there is a remaining balance, they should always: Select one: a. send an appeal to the insurance company for the balance b. write off the remaining balance c. bill the patient for the balance d. determine the appropriate course of action Clear my choice Question 15 Not yet answered Points out of 1.00 Flag question Question text When billing secondary insurances, which of the following is NOT true? Select one: a. The secondary insurance is billed at the same time the primary insurance is. b. Blocks 9a-d of the CMS 1500 claim form must be completed. c. Block 30 of the CMS 1500 claim form must be completed. d. If the Medicare Administrative Contractor automatically forwards the claim to the secondary insurance, there is no need to bill the secondary insurance. Clear my choice Question 16 Not yet answered Points out of 1.00 Flag question Question text Insurance claims transmitted electronically are usually paid in Select one: a. 1 day. b. 2 weeks or less. c. 3-4 weeks. d. 4-6 weeks. Clear my choice Question 17 Not yet answered Points out of 1.00 Flag question Question text The reason for a claim denial is usually identified on the remittance advice with a reason code that translates to a specific denial description. Select one: a. True b. False Clear my choice Question 18 Not yet answered Points out of 1.00 Flag question Question text A transmission report which identifies the total number of claims, charges and dollar amounts that were received by the clearinghouse and identified as clean claims that could be submitted to a specific insurance plan: Select one: a. send and receive file reports b. scrubber report c. transaction transmission summary d. rejection analysis report Clear my choice Question 19 Not yet answered Points out of 1.00 Flag question Question text Delinquent claims are claims that have not been paid: Select one: a. within 15 days of the service date b. within 13-30 days of the service date c. within 30-45 days of the service date d. within 45-60 days of the service date Clear my choice Question 20 Not yet answered Points out of 1.00 Flag question Question text Uniform patient identifiers: Select one: a. were required on all claims effective May 23, 2007 b. were required on all claims effective October 1, 2012 c. were required on all claims effective October 1, 2014 d. are not yet required, and the proposal is on hold for implementation of the standard Clear my choice Question 21 Not yet answered Points out of 1.00 Flag question Question text All of the following are responsibilities of the insurance payment poster EXCEPT Select one: a. posting insurance reimbursements for every code submitted in the insurance claim. b. adjusting the amount charged to match the allowable charge. c. filing the appeal for denial. d. sending statements for patient deductibles and coinsurance balances. Clear my choice Question 22 Not yet answered Points out of 1.00 Flag question Question text The exchange of data in a standardized format through computer systems is known as electronic data interchange. Select one: a. True b. False Clear my choice Question 23 Not yet answered Points out of 1.00 Flag question Question text A clearinghouse is a/an Select one: a. regional office that “clears” the signal for electronic insurance claim transmission. b. entity that receives transmission of insurance claims, separates the claims, and sends each one electronically to the correct insurance payer. c. corporation hired by the insurance company to review claims for payment. d. computer software system that can be purchased by the physician’s office for electronic insurance claims transmission. Clear my choice Question 24 Not yet answered Points out of 1.00 Flag question Question text An insurance claim for a service that has been bundled with other services would be Select one: a. paid. b. rejected. c. suspended. d. denied. Clear my choice Question 25 Not yet answered Points out of 1.00 Flag question Question text A transmission report which identifies the most common reasons for claim denial is the Select one: a. send and receive file reports. b. scrubber report. c. transaction transmission summary. d. rejection analysis report

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