If the insurance plan has a hold harmless clause, it means that the patient is
a. charged for fees by the health care provider, per the EOB.
b. automatically has lower out-of-pocket health care expenses.
c. not responsible for paying what the insurance plan denies.
d. required to pay any amounts that the insurance plan denies.
Question 2
What is the national correct coding initiative?
A. a set of guidelines developed in 1996 intended to reduce incorrect coding and improper overpayments or underpayments through the identification of codes that may or may not be utilized together or that are medically unlikely
B. A qualified healthcare professional who is not a physician but who is authorized to practice medicine, is licensed and registered with the state in which he or she practices medicine, and is authorized to prescribe controlled substances during the management and treatment of a patient; also called a midlevel practitioner
C. A 38-chapter compendium of guidelines for reporting healthcare claims; maintained and updated by CMS
D. a national organization composed of multidisciplinary volunteers dedicated to providing authoritative guidance on the standards for content and data for noninstitutional healthcare claims; maintains and updates the CMS-1500 claim form
Documenting the health history is a crucial step in providing patient care
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