If a patient has an out of state Blue Cross and Blue Shield plan, where would you send claim?

A:  Local Blue Cross and Blue Shield.

If a patient has Medicare and Blue Cross and Blue Shield and is working for a company with more than 15 employees, which insurance would be primary?

A: Blue Cross and Blue Shield

If a patient has Medicare and Blue Cross and Blue Shield and is retired, which insurance would be primary?

A: Medicare

To what code would you attach the 25 modifier?

A: Office Visit

If an Office visit and a procedure is billed on the same day by the same provider, but is distinctively different, what modifier would you use?

A: 25

Which Medicare pays medical providers for healthcare services? Part A or B?

A: Part B

What is the purpose of a superbill?

A: A superbill contains the procedures and diagnosis for a patient’s medical visit. The biller uses this information to submit a claim to the proper insurance payer.

What form are professional claim submitted on?

A: HCF-1500 or CMS-1500

The acronym RA stands for?

A: Remittance Advice

What does POS stands for?

A: Place of Service

What does TOS stands for?

A: Type of Service

What percent of the allowable amount does Medicare pay?

A: 80%

Please tell me the name of the codes that describe diagnosis.

A: ICD?9 or International Classification of Diseases

Please tell me the name of the codes that describe procedures.

A: CPT or Current Procedural Terminology

Are you certified in Medical Billing?

A: Medical Billing Certifications include-
 - Certified Medical Billing Specialist (CMBS) Medical Association of Billers
 - Certified Billing Specialist (CMS) Med-Certification
 - Certified Billing & Coding Specialist (CBCS) Med- Certification
 - Certified Healthcare Reimbursement Specialist (CHRS) National Electronic Biller Alliance

What specialties have you billed?

A: Hire Medical Billers that have billed for your specialty.