Question

CALCULATING COINSURANCE AND DEDUCTIBLE Use this information as you answer the follovwing questions Patient: Zach Green Deductible: $750 Coinsurance: 80/20 Patient out-of-pocket expense maximum $2,000 During Zach's first visit of the year, he incurred a $500 bill. Who pays this bill?, During Zach's second visit of the year, he incurred a S450 bill. Describe how the insurance carrier. 1. much is paid by Zach and s Zach had surgery, which was his third claim of the year. He had a bill of $5,000.c iw Zach's responsibility for this bill and what is the responsibility of the prior lity for this bill and what is the responsiblity of the insurance carrier? How much is Zach responsible for so far this year, considering his first three visits? 4. CHAPTER REVIEW Circle the correct anstver ,. To examine claims for accuracy and complete5. Claims with incorrect, missing or insuffidien ness before they are submitted is tothe claims. data are called: a. clean b. dingy a. correct b. audit c revise d. reject d. dirty Which is a common reason why insurande 6. claims are rejected? a. when a procedure listed is not an insurance benefit Block 1 of the CMS-1500 form contains what 2. information? a. patient's name b. insured's name medical necessity preauthorization not obtained d. b. c type of insurance coverage d carrier address c. all of the above 3. The patient's name is found in block Which is a fixed amount per visit that is typi- cally paid at the time of medical services? a. copayment b. deductible 7. coinsurance d. both a and b c. CPT codes are found in what block? 4. а, 24а 8. Patients sign a(n) of benefits form so that the physician will receive payment for services directly a. release 24b c. 24d d. 24e b. assignment c. turning d. sending Copyright 02019, Elsevier Inc. All Rights Reserved

Answer 1

1. The correct option is b) audit . To check the accuracy and completeness the claims are first send to audit .

2. The correct option is c) type of insurance coverage . Block 1 of the CMS - 1500 form contains types of insurance coverage .

3. The correct option is b) 2. The patients name is found in block 2.

4. The correct option is b) 24b. CPT codes are found in 24b block