Exam Preview for 34425: Managing Managed Care: Audiology and Hearin

Managing Managed Care: Audiology and Hearing Aids in a Third-party World

Please note: exam questions are subject to change.

1. According to this presentation, who should complete the superbill or electronic encounter? Provider Front office staff Manager Owner
2. According to this presentation, when should insurance information obtained for a potential hearing aid patient? Date of scheduling Date of first appointment Date of fitting Do not need patient’s insurance information.
3. An “up to X dollar” hearing aid benefit means: $2500 per ear Usual and customary rate Allowable rate Billed charges
4. According to this presentation, when should patient financial responsibility be taken? Date of service After billing and processing by third party payer After 30 days After 60 days
5. According to this presentation, when should claims be posted: Within one month of the date of service. Within two weeks of the date of service. Within one week of the date of service. Within two business days of the date of service.
6. TPA stands for: Third-payer administrator Third-party act Third-party audiologist Third-party administrator
7. According to this presentation, when should insurance verification processes be completed: Prior to the date of service. On the date of service. After the date of service. None of the above
8. How should insurance verification processes be completed? Through knowledge of the contract and allowable rate schedule. Online, via payer portals. Via a phone call verifying specific benefits. All of the above
9. When using an insurance waiver: The clinic bills the third party payer. The patient bills the third-party payer. Neither the patient nor the clinic bills the third-party payer. None of the above
10. Insurance verification is: A guarantee of payment. A process of estimating coverage and benefits for a specific patient. Third-party contracting. Always able to completed online.