Medical Billing and Coding Interview Questions & Answers

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

Answer :

EOB

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

Answer :

Remittance Advice

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

Answer :

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

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

Answer :

Co-pay

Question 5. What Is Dx Refer To?

Answer :

Diagnosis code

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

Answer :

Heart

Question 7. What Is A Premium?

Answer :

The amount paid for an insurance policy

Question 8. What Is Cobra Insurance?

Answer :

Insurance available to individuals after they become unemployed

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

Answer :

referral

Question 10. What Is Effective Date?

Answer :

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.

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

Answer :

True

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

Answer :

The place of service where services were rendered.

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

Answer :

HIPAA

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

Answer :

Premium

Question 15. What Does Cob Commonly Refer To?

Answer :

Coordination of Benefits

Question 16. What Is Cobra?

Answer :

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.

Question 17. What Do The Cpt Codes Refer To?

Answer :

The procedures performed by a physician or a practitioner

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

Answer :

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

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

Answer :

True

Question 20. Hipaa Stands For:

Answer :

Health Insurance Portability Accountability Act

Question 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.

Answer :

Balanced

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

Answer :

Transition

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

Answer :

Medicare

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

Answer :

January

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

Answer :

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

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

Answer :

DME

Question 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.

Answer :

The above statment is True.

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

Answer :

Fee-for-Service

Question 29. What Is Capitation?

Answer :

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

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

Answer :

Explanation of Benefits

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

Answer :

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

Question 32. Which Would You Likely Use If Billing Medicare?

Answer :

HCFA1500

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

Answer :

ADT

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

Answer :

Part D

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

Answer :

Federal Tax Identification Number

Question 36. What Is A Clearing House?

Answer :

Intermediary between provider and insurance

Question 37. What Is Upcoding?

Answer :

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.

Question 38. What Is V-code?

Answer :

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

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

Answer :

Assignment of Benefits

Question 40. Who Is Eligible For Medicare Part C?

Answer :

An individual who is covered under Parts A and B.

Question 41. What Does Ucr Stand For?

Answer :

Usual, customary, or reasonable

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

Answer :

Place of Service

Question 43. What Are Modifiers Used For?

Answer :

They are used to add more information about a CPT code

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

Answer :

Four numeric digits

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

Answer :

UB04

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

Answer :

10

Question 47. Which One Was Known As Medicare + Choice?

Answer :

Part C

Question 48. What Is Ancillary Care?

Answer :

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

Question 49. What Is Revenue Code?

Answer :

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.

Question 50. Tricare Was Formerly Known As

Answer :

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

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

Answer :

The biller may not be able to contact the physician

Question 52. What Is Actuarial Balance?

Answer :

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