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| Medical Billing
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Description:
Our Medical Billing (U.S.) test measures your knowledge of medical billing procedures and regulations under the various health plans popular in the United States. Designed for experienced hospital administrators, this test covers the following topics: HIPAA, Managed Care, Medicaid, Medical Billing Basic Knowledge, Medical Billing Documents, Medical Billing Process, Medical Terminology, Medicare, Specialty Billing, and TRICARE.
This test will verify an individual's knowledge of the concepts and subjects tested. The results of this test do not imply that the individual possesses the necessary skills to perform a specific procedure, nor treatment, nor is licensed, nor authorized, to practice any health care profession under any applicable laws.
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- CHAMPUS
- Eligibility
| - Electronic Claims
- Positive vs negatives, government regulations
- Purpose
| - HIPAA
- Electronic Claims
- Information Security
- Patient Privacy
| - Managed Care
- Capitation
- Non-covered Services
- PPO vs HMO
- Pre-authorization
- Pre-authorization & Pre-certification
- Referrals
| - Medicaid
- Basic Services
- Eligibility
- Managed Care
- Out of State
| - Medical Billing
- CPT Coding
- HCFA Forms
- ICD-9CM
- Purpose
| - Medical Billing Basic Knowledge
- CPT-4 Coding
- HCPCS Codes
- ICD-9-CM
| - Medical Billing Documents
- CMS Form 1500
- Insurance Contract
- UB-92
- Understanding the EOB
| - Medical Billing Process
- Accounts Receivables Recovery
- Claim Denials
- Copays, Co-Insurance & Deductibles
- Managed Care, PPO, POS, IPA, & Capitation
- Verification of Benefits
| - Medical Terminology
- ICD-9CM
- Insurance Terms
- Prefixes
- Roots
- Specialists
- Suffixes
| - Medicare
- 3-Coding Level
- As Secondary Payor
- Eligibility
- Managed Care
- Medigap
- Part A
- Part B
- UPIN#
| - Specialty Billing
- ERISA Benefit Requirements
- ERISA Eligibility
- Workers' Comp Awareness
- Workers' Comp Processing
| - TRICARE
- Eligibility
- Fiscal Intermediary
- Plans
| - Workman's Comp
- Definition
- FECA Program
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