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| Section | Objectives |
|---|---|
| Topic 1: Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
| Topic 2: Revenue Cycle Management | - Payment posting and reconciliation - Claims denial and rejection management - Accounts receivable follow-up |
| Topic 3: Coding and Claim Submission Basics | - ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance - Claims submission processes |
| Topic 4: Medical Billing Fundamentals | - Healthcare reimbursement systems - Insurance types and payer structures - Medical billing workflow and revenue cycle |
| Topic 5: Insurance Processing and Payer Rules | - Private insurance policies and contracts - Medicare and Medicaid guidelines - Coordination of benefits (COB) |
1. EDD
A) (California) Employment Development Department
B) Electronic funds transfer
C) Employer group health plan
D) Electronic data interchange
2. What does it mean by dacry?
A) tear
B) stool
C) urine
D) sweat
3. Case law is also common law; based on a court decision that establishes a precedent.
A) TRUE
B) FALSE
4. EPSDT
A) Employee Retirements income security Act of 1974
B) Early and Periodic screening, diagnostic, and treatment
C) Electronic Remittance Advice
D) External Quality Review Organization
5. Ambulance Fee Schedule is payment system for ambulance services provided to Medicare Beneficiaries.
A) TRUE
B) FALSE
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: A | Question # 4 Answer: B | Question # 5 Answer: A |
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