MPM102 Chapter 10 Review

smallest units
Data elements are the _______________ of information in a transaction.
from the point of view of the practice, HIPAA 276 is an outgoing transaction, whereas HIPAA 277 is in an incoming transaction
Determine which of these statements is correct ________________
for specific patiesnt
for transactions under a certain dollar amount
for specific payers
ALL OF THE ABOVE ARE CORRECT
In Medisoft Network Professional, filters can be used to create claims _______________
bottom
Once the List Only….filters have been applied, only the claims that match the criteria are listed at the ___________________ of the main Claim Management dialog box.
cannot easily be read because it prints out in a computer format that removes blank spaces
A printout of paper claim is easy to read; a printout of a HIPAA claim __________________
National Uniform Claim Committee (NUCC)
The _______________________ determines the content of both the HIPAA 837 & the CMS 1500.
Carrier 2 and Carrier 3
The ___________________ tab(s) in Medisoft Professional Claim’s dialog box display(s) information about claims being submitted to a patient’s nonprimary insurance carriers.
activities
Revenue Management is accessed via the ________________ menu of Medisoft Network Professional.
medical review program
The _________________ of the payer checks for medical necessity.
transactions
To review claim information about a patient’s visit in October for management of diabetes, choose the __________________ tab of the Claim dialog box.
assigned or attending
The radio buttons in the Provider box of Medisoft Create Claims dialog box indicate whether the provider is the ____________ provider.
subscriber
On the HIPAA claim, the term __________ is used in place of insured on the paper claim.
delete claim button
The ____________ in Medisoft Network Professional’s Claim Management dialog box deletes the selected claim and releases the transactions bound to the claim.
clearinghouse
Most providers use an outside service called a ________________ to help them send their electronic claims to payers.
before claims are transmitted
When is the process of reviewing claims for accuracy ideally done?
indicate a complimentary claim
Use the Complimentary Crossover box in the EDI/Eligibility tab of the Insurance Carrier dialog box, rather than the same box on the Policy 2 tab, to_____________________
initial processing
The first step of the five in the process of adjudication is __________________
suspended
During the payer’s adjudication process, if the automated review finds problems, the claim is ________________ and set aside for development.
claim status
frequency type
BOTH A AND B ARE CORRECT (answer)
Compare the Carrier 1 and the Carrier 2 tabs of the Medisoft Network Professional’s Claim dialog box. The unique boxes in the Carrier 1 tab are _____________________
claim turnaround time
State prompt payment laws mandate a time period known as ________________ within which clean claims must be paid.
automated
A(n) ______________ review checks for bundled codes, among other things.
edit
The edit button at the bottom of Medisoft Network Professional’s Claim Management dialog box opens a claim for reviewing and revising.
the claim attachment is available at the provider’s site
In Medisoft Network Professional, what does the report transmission code AA indicate?
ANSI edits
user-defined edits
common edits
ALL OF THE ABOVE ANSWERS ARE CORRECT (answer)
Before claims are sent, Medisoft Network Professionals performs edits, including __________________
insurance aging report
The PM/EHR can create a(n) ________________ listing the claims transmitted on each day and how long they have been in process with a particlar payer.