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| Section | Weight | Objectives |
|---|---|---|
| Billing Regulations | 13% | - Payer payment policies - CMS-1500, UB-04 completion - ACOs, NCCI, LCDs, NCDs - Incident-to billing, global packages |
| Claims and Billing | 14% | - Claim submission, tracking, follow-up - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections |
| Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers - Medical necessity |
| Case Analysis | 17% | - End-to-end billing scenarios - Adjudication and resolution - Eligibility verification |
| Reimbursement and Collections | 14% | - Payment posting, adjustments - Accounts receivable management - Patient statements, collections - Refunds, payment plans, write-offs |
| Types of Insurance | 21% | - Managed care plans - Medicare, Medigap, Medicaid - Third-party liability - Commercial payers - TRICARE/CHAMPUS, Workers' compensation |
| HIPAA and Compliance | 9% | - Medical record retention - Privacy, security, transaction standards - Fraud, abuse, False Claims Act - Compliance programs |
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NEW QUESTION # 189
Accept Assignment
Answer: B
NEW QUESTION # 190
What does it mean by ipsi?
Answer: A
NEW QUESTION # 191
What does BC stand for?
Answer: B
NEW QUESTION # 192
The medical word root "ankyl/o" (or "ankyl") means:
Answer: C
NEW QUESTION # 193
extra
Answer: C
NEW QUESTION # 194
......
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