Describe the three things a provider agrees to do when a contract is signed with BC/BS to become a participating provider.
What will be an ideal response?
-Submit claims for all BC/BS subscribers.
-Adjust the difference between the amount charged by the provider and the approved or allowed fee on all covered services, which are identified in the insurance plan.
-Bill patients for only the deductible or copayment amounts that are based on the BC/BS allowed fee for covered services.
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Answer the following statements true (T) or false (F)
1. Only adults over 65 are eligible for Medicare. 2. Not all physicians have to be participating providers in the Medicare program. 3. Fraud and abuse mean the same thing. 4. Medicare Part A and B come together. 5. Centers for Medicare and Medicaid Services is the new name for the old Health Care Finance Administration.
Which of the following applies to HIPAA requirements?
A. Patients should know the long-term costs of treatment choices. B. Patients should know the identity of people involved in care. C. Patients should be informed of available resources for resolving disputes. D. Healthcare facilities must inform patients, in writing, about disclosure of identifiable health information. E. To the extent permitted by law, patients may refuse treatment.
According to the U.S. Department of Labor, Bureau of Labor Statistics, medical assistants are listed in the top ten occupations with the employment growth much faster than average through which of the following years?
a. 2010 b. 2024 c. 2009 d. 2020
Physician Office Note:
This five-year-old patient has had recurrent attacks of tonsillitis, loss of appetite, and recurrent colds. He is seen today and is found to have another attack of tonsillitis, which at this point is determined to be chronic. I have discussed with his parents the need to see an ENT for possible tonsillectomy. Select the appropriate ICD-9-CM code(s). 463 Acute tonsillitis 474.00 Chronic tonsillitis 460 Common cold 783.0 Loss of appetite A) 463, 474.00, 460, 783.0 B) 463 C) 474.00 D) 474.00, 463, 460, 783.0