Question 1

What can be used to track payments from a health plan?

Accepted Answer

A)   claim control number
B)   line control number
C)   reference number
D)   both the claim control number and the line control number

Question 2

A unit of information on a HIPAA claim is called a data

Accepted Answer

A)   analysis
B)   control number
C)   report card
D)   element

Question 3

The taxonomy codes are one of the nonmedical or nonclinical

Accepted Answer

A)   administrative code sets
B)   claim forms
C)   fee schedules
D)   none of these

Question 4

What happens when a primary payer forwards the COB transaction?

Accepted Answer

A)   a message appears on the primary payer's RA
B)   there is no need for a RA
C)   the secondary payer pays in full
D)   it turns into a clean claim

Question 5

Which of these is associated with payers?

Accepted Answer

A)   National Individual ID
B)   National Payer ID
C)   National Provider Identifier
D)   National Uniform Claim Committee

Question 6

What does a place of service (POS)  code describe about a service provided?

Accepted Answer

A)   office number
B)   hospital room
C)   location
D)   none of these

Question 7

How many digits are in a taxonomy code?

Accepted Answer

A)   eight
B)   ten
C)   twelve
D)   it varies by the situation

Question 8

What do primary payers issue to detail how a claim was processed, in order for a secondary claim to be submitted?

Accepted Answer

A)   fee slip
B)   Explanation of Benefits
C)   Remittance Advice
D)   walkout receipt

Question 9

What is considered when the NUCC revises the paper claim?

Accepted Answer

A)   CMS-1500
B)   HCFA-1500
C)   HIPAA claim
D)   UB 04

Question 10

What is an RA (remittance advice) ?

Accepted Answer

A)   detailed account of why a claim was denied
B)   paper form
C)   detailed account of how the claim was processed
D)   benefits explanation

Question 11

Which is not a major method of transmitting claims electronically?

Accepted Answer

A)   clearinghouse
B)   e-mail
C)   direct transmission
D)   direct data entry

Question 12

On the HIPAA claim, what code is required to specify the patient's relationship to the subscriber when the patient and the subscriber are not the same person?

Accepted Answer

A)   individual relationship code
B)   claim filing indictor code
C)   claim submission reason code
D)   patient code

Question 13

The NUCC can be expected to continue to update what form?

Accepted Answer

A)   CMS-75 form
B)   Medicaid form
C)   NUCC form
D)   CMS-1500 form

Question 14

The claim frequency code is sometimes known as the

Accepted Answer

A)   claim adjudication number
B)   claim submission reason code
C)   provider number
D)   None of these

Question 15

When are claims prepared for transmission?

Accepted Answer

A)   after receiving COB
B)   after receiving EOB
C)   after the patient leaves the office
D)   after data elements have been posted to the PMP

Question 16

A code indicating what a number represents is a

Accepted Answer

A)   qualifier
B)   quantifier
C)   transaction
D)   none of these

Question 17

The organization or person transmitting the claim to the payer is the

Accepted Answer

A)   billing provider
B)   pay-to provider
C)   physician
D)   patient

Question 18

What does the abbreviation EMC stand for?

Accepted Answer

A)   electronic miscellaneous claims
B)   electronic Medicare claims
C)   electronic media claims
D)   electronic master codes

Question 19

What is another name for the CMS-1500?

Accepted Answer

A)   paper claim form
B)   e-form
C)   837P claim
D)   HIPAA claim

Question 20

Which association leads the National Uniform Claim Committee (NUCC) ?

Accepted Answer

A)   HIPAA Association
B)   Central Medical Association
C)   American Medical Association
D)   American Association for Medical Assistants

Exam 7: Health Care Claim Preparation and Transmission

The taxonomy codes are one of the nonmedical or nonclinical

Correct AnswerverifiedShow Answer

What is an RA (remittance advice) ?

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Which association leads the National Uniform Claim Committee (NUCC) ?

Correct AnswerverifiedShow Answer

A unit of information on a HIPAA claim is called a data

Correct AnswerverifiedShow Answer

A code indicating what a number represents is a

Correct AnswerverifiedShow Answer

The claim frequency code is sometimes known as the

Correct AnswerverifiedShow Answer

When are claims prepared for transmission?

Correct AnswerverifiedShow Answer

What can be used to track payments from a health plan?

Correct AnswerverifiedShow Answer

The organization or person transmitting the claim to the payer is the

Correct AnswerverifiedShow Answer

What is considered when the NUCC revises the paper claim?

Correct AnswerverifiedShow Answer

How many digits are in a taxonomy code?

Correct AnswerverifiedShow Answer

What happens when a primary payer forwards the COB transaction?

Correct AnswerverifiedShow Answer

What does the abbreviation EMC stand for?

Correct AnswerverifiedShow Answer

The NUCC can be expected to continue to update what form?

Correct AnswerverifiedShow Answer

Which is not a major method of transmitting claims electronically?

Correct AnswerverifiedShow Answer

What is another name for the CMS-1500?

Correct AnswerverifiedShow Answer

What do primary payers issue to detail how a claim was processed, in order for a secondary claim to be submitted?

Correct AnswerverifiedShow Answer

What does a place of service (POS) code describe about a service provided?

Correct AnswerverifiedShow Answer

Which of these is associated with payers?

Correct AnswerverifiedShow Answer

On the HIPAA claim, what code is required to specify the patient's relationship to the subscriber when the patient and the subscriber are not the same person?

Correct AnswerverifiedShow Answer

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