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| Section | Objectives |
|---|---|
| Topic 1: Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Medicare and Medicaid guidelines - Private insurance policies and contracts |
| Topic 2: Revenue Cycle Management | - Accounts receivable follow-up - Payment posting and reconciliation - Claims denial and rejection management |
| Topic 3: Compliance and Regulations | - HIPAA and patient privacy rules - Fraud and abuse prevention - Billing compliance standards |
| Topic 4: Coding and Claim Submission Basics | - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes |
| Topic 5: Medical Billing Fundamentals | - Healthcare reimbursement systems - Medical billing workflow and revenue cycle - Insurance types and payer structures |
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NEW QUESTION # 222
FCA
Answer: A
NEW QUESTION # 223
HICN stands for Health Insurance claim number.
Answer: A
NEW QUESTION # 224
The medical word root "hepat" or "hepat/o" refers to the:
Answer: B
NEW QUESTION # 225
What are actions inconsistent with accepted, sound medical business or fiscal practice?
Answer: D
NEW QUESTION # 226
What does AMA stand for?
Answer: C
NEW QUESTION # 227
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