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| Section | Weight | Objectives |
|---|---|---|
| Billing Regulations | 13% | - CMS-1500, UB-04 completion - Incident-to billing, global packages - Payer payment policies - ACOs, NCCI, LCDs, NCDs |
| Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity - Code validation, modifiers |
| Reimbursement and Collections | 14% | - Patient statements, collections - Payment posting, adjustments - Accounts receivable management - Refunds, payment plans, write-offs |
| Case Analysis | 17% | - Eligibility verification - End-to-end billing scenarios - Adjudication and resolution |
| Claims and Billing | 14% | - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections - Claim submission, tracking, follow-up |
| HIPAA and Compliance | 9% | - Privacy, security, transaction standards - Compliance programs - Fraud, abuse, False Claims Act - Medical record retention |
| Types of Insurance | 21% | - Medicare, Medigap, Medicaid - Third-party liability - Managed care plans - Commercial payers - TRICARE/CHAMPUS, Workers' compensation |
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NEW QUESTION # 84
ABN stands for Advance Beneficiary Notice.
Answer: B
NEW QUESTION # 85
What does AHFS stand for?
Answer: A
NEW QUESTION # 86
contra
Answer: A
NEW QUESTION # 87
What does it mean by inter?
Answer: B
NEW QUESTION # 88
American Association of Medical Assistants (AAMA) enables medical assisting professionals to enhance and demonstrate the knowledge, skills, and professionalism required by employers and patients; as well as protect medical assistants' right to practice.
Answer: B
NEW QUESTION # 89
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