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Chapter Quiz
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1
An appeal is sent to third-party payers before a questionable claim is transmitted.
A)True
B)False
2
The claimant is the person or entity who seeks to receive benefits.
A)True
B)False
3
The claim turnaround time is the period between the patient's encounter and the transmission of the resulting claim.
A)True
B)False
4
Medical insurance specialists follow up on claims that are not processed within the specified claim turnaround time for the payer.
A)True
B)False
5
An example of concurrent care is a case in which a patient is attended by two physicians, such as a cardiologist and a thoracic surgeon, during surgery.
A)True
B)False
6
The determination of a claim refers to the payer's decision regarding payment.
A)True
B)False
7
An insurance aging report lists the practice's patients, their insurance information, and their ages.
A)True
B)False
8
A medical necessity denial occurs when a procedure is halted by a provider because of the patient's condition.
A)True
B)False
9
A medical review program is established by a third-party payer.
A)True
B)False
10
A utilization review is conducted by provider to check the medical necessity of claims before they are transmitted.
A)True
B)False





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