If a Claim Is Denied Because Services Were Provided Before

question 98

Multiple Choice

If a claim is denied because services were provided before insurance coverage was in effect, the medical office specialist should:

• A) bill the patient.
• B) write off the entire amount.
• C) wait until the effective date of the coverage, then bill the insurance carrier.
• D) change the date of service and resubmit the claim.

Understand the legal and procedural mechanisms for protecting domestic industries from unfair international trade practices such as dumping.

Recognize the significance of international licensing agreements and the key components that should be included in such agreements.

Understand the extraterritorial application of certain country’s laws and its impact on international trade.

Grasp the concept of NAFTA and rules of origin in trade agreements.

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Definitions:

Pain Control

The management and reduction of pain using various strategies, including medication, physical therapy, and alternative methods.

The Joint Commission

An independent, not-for-profit organization that accredits and certifies nearly 21,000 health care organizations and programs in the United States, aiming to improve health care for the public.

Sentinel Events

Unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof, which signal the need for immediate investigation and response.

Documentation Audits

The systematic review of records and documents to ensure accuracy, compliance, and quality in various settings, especially healthcare.