Working with EOBs – KMC University

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Question 1 of 10

1. Question
1. What is the online version of the Medicare payment statement called?
- Explanation of Review
- Statement of Accounts Payable
- Electronic Remittance Advice (ERA)
- Virtual Payment Notification
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Question 2 of 10

2. Question
2. How is the amount that is paid to the provider by a third-party determined?
- Allowed amount minus the patient’s deductible, co-pay, and/or coinsurance
- Patient’s deductible plus the amount billed
- Co-insurance percentage multiplied by the amount billed
- Allowed amount minus provider discount
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Question 3 of 10

3. Question
3. What type of EOB might contain information about an auto accident?
- Commercial Insurance
- Medicare
- Medicaid
- Personal Injury
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Question 4 of 10

4. Question
4. What must be done when a contractual provider discount applies to a claim?
- You must raise your fees to stay competitive with other chiropractors in your area
- This amount should be written off and not balance billed to the patient
- The provider will collect that amount later in a bonus check for being in-network
- The patient can collect this amount from the office if they have a discount card
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Question 5 of 10

5. Question
5. What type of EOB often lists the automatic crossovers to secondary and/or supplemental insurance?
- Commercial insurance
- Workers Compensation
- Personal Injury
- Medicare
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Question 6 of 10

6. Question
6. What Place of Service code is most often seen on chiropractic EOBs performed in the office?
- CR-15
- 21
- 11
- IPF
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Question 7 of 10

7. Question
7. Online portals are usually the best place to manage EOBs and track down 3^rd party payments.
- True
- False
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Question 8 of 10

8. Question
8. Which of the following may result in a reduced or non-payment on an EOB?
- A recoupment from a previously processed claim
- Annual fee to be in-network with an insurance company
- Claims processing charge from the insurance company
- Pediatric patients may only be billed 50% of the adult allowable fee
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Question 9 of 10

9. Question
9. What information might you find on the Worker’s Compensation Portal?
- The date the patient can go back to work
- Where the patient will be working
- The amount and date a claim is paid
- How many employees the employer has
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Question 10 of 10

10. Question
10. A Personal Injury Explanation of Benefits will often list the
- Date of Loss
- Date of Filed Claim
- Date Patient was got their car fixed
- Date of Initial visit
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