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QUESTION IMAGE

whom does a provider usually employ to perform administrative and clini…

Question

whom does a provider usually employ to perform administrative and clinical tasks to help keep the office or clinic running smoothly?
health information technician
medical assistant
nurse practitioner
reimbursement specialist
question 4 (2.5 points)
which involves linking every procedure or service code reported on the claim to a condition code that justifies the necessity of performing that procedure or service?
claims adjudication
diagnosis coding
medical necessity
reimbursement processing

Explanation:

Brief Explanations
  • For the first question: Medical assistants are trained to handle both administrative (like scheduling appointments, managing patient records) and clinical tasks (such as taking vital signs, assisting with minor procedures) in a medical office or clinic. Health information technicians mainly focus on health data management, nurse practitioners have more advanced clinical roles (like diagnosing and treating patients), and reimbursement specialists deal specifically with insurance claim payments.
  • For the second question: Medical necessity refers to the concept of linking a procedure or service code (what is done for a patient) to a condition code (why it is done, i.e., the medical reason). Claims adjudication is the process of determining if a claim is payable. Diagnosis coding is about assigning codes to patient diagnoses. Reimbursement processing is related to getting paid for services.

Answer:

  • First question: medical assistant
  • Second question: medical necessity