IBM Interview Questions and Answers

Denials can be categorized as hard denials and soft denials, with further denial charges being incurred for repeated denials.

• Types of denials include eligibility denials, coding denials, and timely filing denials.

• Hard denials are denials that are not eligible for resubmission, while soft denials can be corrected and resubmitted.

• Further denial charges may be incurred for repeated denials due to lack of documentation or incorrect coding.

• Examples of further denial charges includ...read more

Modifiers are used to provide additional information about a procedure or service performed, while CPT codes are numeric codes used to describe medical, surgical, and diagnostic services.

• Modifiers are two-digit codes added to CPT codes to indicate that a service or procedure has been altered in some way

• Modifiers can affect reimbursement, denials, and audits

• Examples of modifiers include -25 (significant, separately identifiable evaluation and management service by the same phy...read more

A claim form is a document submitted by a healthcare provider to request payment for services rendered to a patient.

• A claim form includes information such as patient demographics, insurance information, diagnosis codes, procedure codes, and billed amounts.

• It is used by healthcare providers to bill insurance companies or government programs for reimbursement.

• Submitting accurate and complete claim forms is crucial for timely payment and avoiding claim denials.

• Examples of claim ...read more

The two types of modifiers are descriptive and non-descriptive.

• Descriptive modifiers provide additional information about a service or procedure, such as location, time, or method (e.g. bilateral, multiple)

• Non-descriptive modifiers indicate that a service or procedure has been altered in some way, such as for a specific reason or to indicate a special circumstance (e.g. -22, -LT)

Recoupment is the process of recovering overpaid funds or correcting payment errors.

• Recoupment involves recovering funds that were mistakenly paid out in excess.

• It can also refer to deducting money owed from future payments.

• Common in healthcare billing when insurance companies recoup overpayments by deducting from future claims.

• Recoupment can also occur in other industries such as finance or government.

• It is important to closely monitor recoupment activities to ensure accurac...read more

The impact of social media on mental health

• Social media can have both positive and negative effects on mental health

• Excessive use of social media can lead to feelings of loneliness and depression

• Comparison to others on social media can negatively impact self-esteem

• However, social media can also provide a sense of community and support for those struggling with mental health issues