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A medical assistant is submitting an urgent referral request to an insurance company for authorization. Which of the following describes how long the authorize process will take?

A.

24 hr

B.

3 working days

C.

Immediate approval via phone

D.

10 days

Answer and Explanation

The Correct Answer is C

A. 24 hr: Urgent referrals often require quick processing, but it may take longer than 24 hours depending on the insurance company's policies.

 

B. 3 working days: This time frame is more typical for standard, non-urgent referrals.

 

C. Immediate approval via phone: Urgent referrals can sometimes be approved immediately via phone, particularly when immediate care is needed. This is the most appropriate choice for an urgent situation.

 

D. 10 days: Ten days is too long for an urgent referral and is more typical for non-urgent or routine requests.


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View Related questions

Correct Answer is C

Explanation

A. Consent form: A consent form is a document that gives permission for medical procedures or treatments and is not the same as a superbill.

B. Assignment of benefits: Assignment of benefits is a document that allows the insurance company to pay the provider directly, not a billing form used to summarize charges.

C. Encounter form: A superbill is also known as an encounter form. It details the services provided, diagnosis codes, and charges for a patient’s visit.

D. Advanced beneficiary notice: An advanced beneficiary notice informs patients about services that Medicare may not cover and is not related to billing or charges.

Correct Answer is C

Explanation

A. Bone density test: Bone density tests are typically recommended for women starting around age 65 or earlier if risk factors are present, but they are not usually performed annually.

B. Dilated eye exam: While dilated eye exams are important, they are generally recommended every 1-2 years, not annually, unless specific conditions warrant more frequent exams.

C. Papanicolaou (Pap) test: The Pap test is recommended every 3 years for women aged 21-65 or every 5 years with HPV testing for those aged 30-65. Annual documentation is not required, but it is important to monitor this screening as part of preventative care.

D. Mammogram: Mammograms are typically recommended every 1-2 years for women starting at age 40, not annually.

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