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?
24 hr
3 working days
Immediate approval via phone
10 days
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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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.