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| Section | Weight | Objectives |
|---|---|---|
| Reimbursement and Collections | 14% | - Refunds, payment plans, write-offs - Patient statements, collections - Payment posting, adjustments - Accounts receivable management |
| Coding Concepts for Billers | 12% | - Code validation, modifiers - Medical necessity - ICD-10-CM, CPT®, HCPCS Level II |
| Claims and Billing | 14% | - Denials, appeals, corrections - Electronic claims, clearinghouses - Claim submission, tracking, follow-up - Timely filing rules |
| Case Analysis | 17% | - End-to-end billing scenarios - Adjudication and resolution - Eligibility verification |
| Types of Insurance | 21% | - TRICARE/CHAMPUS, Workers' compensation - Third-party liability - Medicare, Medigap, Medicaid - Commercial payers - Managed care plans |
| Billing Regulations | 13% | - Incident-to billing, global packages - ACOs, NCCI, LCDs, NCDs - Payer payment policies - CMS-1500, UB-04 completion |
| HIPAA and Compliance | 9% | - Privacy, security, transaction standards - Fraud, abuse, False Claims Act - Medical record retention - Compliance programs |
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NEW QUESTION # 179
Which part of the body does genit refer to?
Answer: D
NEW QUESTION # 180
What does it mean by adip?
Answer: A
NEW QUESTION # 181
HPSA stands for Health Personnel Shortage Area.
Answer: A
NEW QUESTION # 182
What does it mean by juxta?
Answer: B
NEW QUESTION # 183
DOD
Answer: B
NEW QUESTION # 184
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