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| Section | Objectives |
|---|---|
| Revenue Cycle Management | - Accounts receivable follow-up - Payment posting and reconciliation - Claims denial and rejection management |
| Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
| Coding and Claim Submission Basics | - Claims submission processes - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview |
| Insurance Processing and Payer Rules | - Private insurance policies and contracts - Medicare and Medicaid guidelines - Coordination of benefits (COB) |
| Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Healthcare reimbursement systems - Insurance types and payer structures |
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NEW QUESTION # 17
Which entity is responsible for enforcing HIPAA privacy regulations?
Answer: D
Explanation:
The Office for Civil Rights (OCR), under HHS, enforces HIPAA Privacy and Security Rules.
NEW QUESTION # 18
What does it mean by gluc and glyc?
Answer: D
NEW QUESTION # 19
What does the acronym ERISA stand for?
Answer: B
NEW QUESTION # 20
Adjusted Claim is payment correction resulting in additional payment(s) to the provider.
Answer: B
NEW QUESTION # 21
What does it mean by gyn, gyne and gynec?
Answer: A
NEW QUESTION # 22
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