#1
What is the primary goal of medical billing?
To generate revenue for healthcare providers
ExplanationMedical billing aims to generate revenue by accurately processing and submitting claims for healthcare services.
#2
What is the role of a medical coder in the billing process?
To assign codes to medical procedures and diagnoses
ExplanationMedical coders play a crucial role in assigning accurate codes to procedures and diagnoses, facilitating proper billing and reimbursement.
#3
What does the term 'UB-04' refer to in medical billing?
A billing form used for institutional claims
ExplanationUB-04 is a standardized billing form specifically used for submitting institutional claims in medical billing.
#4
Which code set is commonly used in medical billing for procedures and services?
CPT (Current Procedural Terminology)
ExplanationCPT is a widely used code set in medical billing, specifying procedures and services for accurate billing and reimbursement.
#5
What does the term 'EOB' stand for in the context of medical billing?
Explanation of Benefits
ExplanationEOB provides a detailed explanation of the costs covered, payments, and patient responsibilities after a medical service.
#6
Which organization oversees the implementation of the ICD-10 coding system?
CMS (Centers for Medicare & Medicaid Services)
ExplanationCMS oversees the implementation of the ICD-10 coding system, ensuring standardized coding for healthcare services.
#7
What is a common method used for reimbursement in healthcare?
Third-party payer systems
ExplanationHealthcare reimbursement often involves third-party payer systems, where insurance companies or government programs pay for medical services.
#8
In medical billing, what is the purpose of a 'Clean Claim'?
A claim submitted without any errors or missing information
ExplanationA 'Clean Claim' in medical billing is a submission without errors, ensuring smooth processing and prompt reimbursement.
#9
What is the purpose of the National Provider Identifier (NPI) in medical billing?
To identify healthcare providers in electronic transactions
ExplanationThe NPI is used to uniquely identify healthcare providers in electronic transactions, ensuring accurate record-keeping and communication.