1. What is the role of medical coders and billing people in medical industry?
Answer: The main duties of the individuals involved in the medical coding and billing job are
- Managing and documenting the medical related paper work
- Creating invoices regarding the bill for patients to insurance companies
- Providing the necessary code for each procedure followed in billing system
- Cross checking the patient’s bill coverage with relevant insurance company
2. Name the codes used to describe the diagnosis?
Answer: (ICD -9 or icd-10) international classification of diseases
3. Name the codes which are involved in procedures?
Answer: Current procedural terminology or CPT
4. What is the core purpose of super bill?
Answer: Super bill contains the procedures and diagnosis involved in the medical visit of patient, the biller thereafter uses this information while submitting the claim to relevant insurance player.
5. What is the percentage normally allowed in the Medicare payment?
Answer: 80% is the normal amount to be allowed for Medicare pay.
6. Which Medicare will generally pay for medical providers in the healthcare services - either part A or part B?
Answer: Part B will be used in the payment for medical providers in the healthcare service system.
7. Abbreviate TOS and POS?
- TOS: Type of service
- POS: Place of service
8. The exact abbreviation of RA in medical industry?
Answer: Remittance advice (ERA – Electronic Remittance Advice)
9. What form should be submitted for professional claim?
Answer: HCFA – 1500 or CMS – 1500
10. What is the process involved under medical billing?
- Coding (of the range – CPT, ICD -9, ICD-10, HCPCS)
- Entry of patient demographics
- All specialties wise – charge entry
- Payment of postings (both manual and electronic)
- Reconciliation of payments
- Re-billing and rejection/ denial analysis
- Follow up of accounts receivables
- Re-billing of systemic A/R projects
- Reporting for collection agency
- Refund options