Author Question: A claims examiner employed by a third-party payer reviews health-related claims to determine whether ... (Read 101 times)

Mr.Thesaxman

  • Hero Member
  • *****
  • Posts: 514
A claims examiner employed by a third-party payer reviews health-related claims to determine whether the charges are reasonable, in addition to
 a. assigning ICD-10-CM and CPT codes.
  b. billing patients for copayments and coinsurance.
  c. determining medical necessity of services/procedures.
  d. resubmitting denied claims to health care providers.

Question 2

The process of reporting __________ as numeric and alphanumeric characters on the insurance claim is called coding.
 a. dates of service for procedures
  b. diagnoses and procedures/services
  c. health insurance claims identifiers
  d. national provider identifiers



yasmin

  • Sr. Member
  • ****
  • Posts: 319
Answer to Question 1

c

Answer to Question 2

b



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
 

Did you know?

Asthma occurs in one in 11 children and in one in 12 adults. African Americans and Latinos have a higher risk for developing asthma than other groups.

Did you know?

Though Candida and Aspergillus species are the most common fungal pathogens causing invasive fungal disease in the immunocompromised, infections due to previously uncommon hyaline and dematiaceous filamentous fungi are occurring more often today. Rare fungal infections, once accurately diagnosed, may require surgical debridement, immunotherapy, and newer antifungals used singly or in combination with older antifungals, on a case-by-case basis.

Did you know?

The largest baby ever born weighed more than 23 pounds but died just 11 hours after his birth in 1879. The largest surviving baby was born in October 2009 in Sumatra, Indonesia, and weighed an astounding 19.2 pounds at birth.

Did you know?

On average, someone in the United States has a stroke about every 40 seconds. This is about 795,000 people per year.

Did you know?

Studies show that systolic blood pressure can be significantly lowered by taking statins. In fact, the higher the patient's baseline blood pressure, the greater the effect of statins on his or her blood pressure.

For a complete list of videos, visit our video library