Comp Software Apps Healthcare
Procedure Posting Routines
- Name the three steps involved in the claims management process.
- Provide examples where paper claims might be necessary over electronic claims submissions.
- There are a number of items insurance companies require in order to process medical billing claims. List at least eight (8) of these items.
- Describe the NPI number, implementation advantages of it NPI number, and what type of provider must use the NPI.
- Describe two specific factors that greatly reduce denied claims and limits the amount of insurance follow-up and tracing to be done.
- Describe some ways reimbursement may be affected by a patient who receives services from an out-of-network provider.
- Give examples of times when Medicare is the secondary payer (MSP).
- A patient with Medicare is working at a small business with fewer than 20 employees. She has a group plan with this employer. Which insurance is primary for services? Explain your answer.
- Employer group plan
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