300+ [REAL TIME] Medical Billing and Coding Interview Questions

1. A Remittance Advice Statement Is Most Similar To A(n):

EOB

2. The Exact Abbreviation Of Ra In Medical Billing Terminology?

Remittance Advice

3. Is A Co-payment An Out Of Pocket Expense?

Yes.A co-payment an out of pocket expense.

4. The Predetermined (flat) Fee, A Patient Usually Has To Pay On Each Office Visit Is A:

Co-pay

5. What Is Dx Refer To?

Diagnosis code

6. What Organ Is Measured In An Ekg/ecg?

Heart

7. What Is A Premium?

The amount paid for an insurance policy

8. What Is Cobra Insurance?

Insurance available to individuals after they become unemployed

9. A Patient On An Hmo Plan Typically Needs A _________ To Receive Care From A Specialist.

referral

10. What Is Effective Date?

The date the insurance policy is set to begin or when benefits or covered services are allowed is most commonly known as the Effective date.

11. Sometimes Multiple Treatments Will Fall Under One Billing Code.

True

12. Place Of Service Codes On Claims Are There To Define?

The place of service where services were rendered.

13. Which Federal Law Strengthens The Privacy Of A Patient’s Phi And Allows A Patient To Review Their Medical Record?

HIPAA

14. The Amount Paid, Often In Monthly Installments, For An Insurance Policy By The Employer Or Patient Themselves, Is The:

Premium

15. What Does Cob Commonly Refer To?

Coordination of Benefits

16. What Is Cobra?

The federal law that allows a worker to continue to purchase employer paid health insurance for up to 18 months if they lose their job or your coverage is otherwise terminated is known as COBRA.

17. What Do The Cpt Codes Refer To?

The procedures performed by a physician or a practitioner

18. In Medical Billing, What Is The Function Of A Clearinghouse?

It checks bills for errors then transmits them to the insurance company

19. Tertiary Insurance Is Intended To Cover Gaps In Coverage The Primary And Secondary Insurance May Not Cover?

True

20. Hipaa Stands For:

Health Insurance Portability Accountability Act

21. ________ Billing Is When A Patient Is Charged For The Difference Between What A Doctor Bills And What The Provider And Insurance Company Agree Upon.

Balanced

22. Which Of These Are Not Standard Statuses Of A Claim In A Typical Eob?

Transition

23. Health Insurance Claim (hicn) Is A Number Assigned By The Social Security Administration To An Individual Identifying Him/her As A _______ Beneficiary?

Medicare

24. In Which Month Do Commercial Insurance And Medicare Deductibles Start Each Year?

January

25. If A Physician Uses An Open-panel Hmo, Can They See Non-hmo Patients?

Yes, a physician uses an open-panel HMO, can they see non-HMO patients.

26. Hospital Beds, Wheelchairs And Oxygen Equipment Would Be Considered Examples Of:

DME

27. Awp Laws Are State Laws That Require Health Insurance Companies To Accept Into Their Ppo And Hmo Networks Any Provider Willing To Agree To The Insurance Company’s Terms And Conditions.

The above statment is True.

28. A Type Of Health Coverage That Typically Allows A Patient To Go To Any Doctor Or Provider Without Permission Is Known As:

Fee-for-Service

29. What Is Capitation?

A system that pays physicians and nurses a set amount per enrolled patient assigned to them.

30. When Submitting A Secondary Claim, What Is The Name Of The Document That Must Be Attached?

Explanation of Benefits

31. What Is The Purpose Of An Advanced Beneficiary Notice?

To alert a patient that Medicare may deny payment for a specific procedure or treatment.

32. Which Would You Likely Use If Billing Medicare?

HCFA1500

33. With The Implementation Of Hipaa, All The Following Systems Became Mandatory Except:

ADT

34. Which Part Of Medicare Is The Drug Prescription Coverage?

Part D

35. The Employer Identification Number Is Also Known As The:

Federal Tax Identification Number

36. What Is A Clearing House?

Intermediary between provider and insurance

37. What Is Upcoding?

An illegal practice of assigning an ICD-9 diagnosis code that does not agree with the patient records for the purpose of increasing the reimbursement from the insurance payor is called Upcoding.

38. What Is V-code?

The ICD-9-CM coding classification to identify health care for reasons other than injury or illness is know as V-code.

39. Which Is An Agreement Made Between The Insurance Company And The Insured To Send Payments Directly To The Physician?

Assignment of Benefits

40. Who Is Eligible For Medicare Part C?

An individual who is covered under Parts A and B.

41. What Does Ucr Stand For?

Usual, customary, or reasonable

42. What Could Pos Exactly Stand For In Medical Billing?

Place of Service

43. What Are Modifiers Used For?

They are used to add more information about a CPT code

44. Level Ii Hcpcs Codes Are Formatted As A Single Letter Followed By _________.

Four numeric digits

45. The Claim Form For Billing For Facility Fees Which Replaces The Ub92 Form Is The _______ Form.

UB04

46. How Many Digits Are In A National Provider Identifier?

10

47. Which One Was Known As Medicare + Choice?

Part C

48. What Is Ancillary Care?

Medical care, other than those provided by the physician or hospital, which are related to a patient’s care, are called Ancillary care.

49. What Is Revenue Code?

A 3-digit number used on hospital bills to tell the insurer where the patient was when they received treatment, or what type of item a patient received, is the Revenue Code.

50. Tricare Was Formerly Known As

Civilian Health and Medical Program of the Uniformed Services(CHAMPUS).

51. What Is A Challenge Of Processing Medical Bills Off Site?

The biller may not be able to contact the physician

52. What Is Actuarial Balance?

The difference between the summarized income rate and the summarized cost rate over a given valuation period is the Actuarial Balance.