What is the purpose of medical coding in the billing process?
Medical coding translates healthcare services into standardized codes used for billing and insurance reimbursement.
Which government program provides healthcare coverage for individuals aged 65 and older?
Medicare is a federal insurance program that provides healthcare coverage for individuals aged 65 and older or with certain disabilities.
What is the purpose of a claim denial appeal in medical billing?
A claim denial appeal allows providers to request a review of an insurance denial and provide additional documentation for reimbursement.
Which type of insurance plan requires patients to choose a primary care provider (PCP)?
Health Maintenance Organizations (HMOs) require patients to select a primary care provider and get referrals for specialist visits.
What does the Explanation of Benefits (EOB) provide to patients?
The EOB is a document from the insurer outlining what services were covered, the amount paid, and any patient responsibility.
What is a common reason for insurance claim rejections?
Insurance claims can be rejected due to coding errors, missing information, or lack of medical necessity.