Medical Billing and Coding Interview Questions

by admin on September 2, 2012

Prior to knowing the list of question and answers in the interview, one must know the duties of the medical coders and billing professions clearly.

What is the role of medical coders and billing people in medical industry?

The main duties of the individuals involved in the medical coding and billing job are

  • Managing and documenting the medical related paper work
  • Creating invoices regarding the bill for patients to insurance companies
  • Providing the necessary code for each procedure followed in billing system
  • Cross checking the patient’s bill coverage with relevant insurance company

Medical billing and coding – Question and answers – Interview purpose

Name the codes used to describe the diagnosis?

ICD -9 or International classification of diseases

Name the codes which are involved in procedures?

Current procedural terminology or CPT

What is the core purpose of super bill?

Super bill contains the procedures and diagnosis involved in the medical visit of patient, the biller thereafter uses this information while submitting the claim to relevant insurance player.

What is the percentage normally allowed in the Medicare payment?

80% is the normal amount to be allowed for Medicare pay

Which Medicare will generally pay for medical providers in the healthcare services – either part A or part B?

Part B will be used in the payment for medical providers in the healthcare service system

Abbreviate TOS?

Type of service

What could exactly POS stand for?

Place of service

The exact abbreviation of RA in medical industry?

Remittance Advice

What form should be submitted for professional claim?

HCF – 1500 or CMS – 1500

What is the process involved under medical billing?

  • Coding (of the range – CPT, ICD -9, HCPCS)
  • Entry of patient demographics
  • All specialties wise – charge entry
  • Payment of postings (both manual and electronic)
  • Reconciliation of payments
  • Re-billing and rejection/ denial analysis
  • Follow up of accounts receivables
  • Re-billing of systemic A/R projects
  • Reporting for collection agency
  • Refund options

What are the common problems you face in medical billing?

  • No proper supporting documentation
  • Claims are often incomplete
  • Inaccurate or lack of proper coding
  • No smooth communication with payer
  • No billing for the services being offered
  • No follow up with AR balance claims on time

What are the duties of medical billing specialist?

  • Insurance verification
  • Patient demography and his charge entry
  • Claims submission
  • Payments posting and its process
  • Denial management
  • Insurance follow-up and management
  • Insurance appeal and its process
  • Handling inquiries under patient billing
  • Processing the patient’s statement
  • Report Preparation and management

What are all the certifications involved in the medical billing and coding field?

There are many certifications for the job seekers in the field of medical coding and billing. Some of them to be mentioned are

  • Certified Medical Billing Specialist ( CMBS)
  • Certified Billing and Coding Specialist ( CBCS)
  • Certified Billing Specialist – Med Certification (CBS)
  • Certified Healthcare Reimbursement Specialist (CHRS)

What are the types of medical coding you well versed?

Though there is a variation to the purpose of medical coding, the types are generally in accordance with the level of work experience.

  • Medical code for the analysis of medical conditions
  • Any Potential outbreak – medical code
  • Insurance reimbursement medical code

The above are some of the well known types in medical code, there are other types which you may come across on the job. Do also learn from your colleagues and friends to acquire more information and knowledge.

What is the main use of CPT codes?

Mainly CPT (Current Procedural Terminology) codes are used for recording the actual level of service for each patient mentioned. Proper understanding of the codes with all its application and usage information can offer you the edge over the others.

What is the motivation you receive in medical coding?

The response is entirely open, as one may find it more rewarding, the other looks for it as more interesting, therefore the reply must be on a more apt and positive note.

Also try and know these questions, with clear responses

  • Which payer is defined as a last resort?
  • Any other names you can suggest for the referring physician?
  • Define the term global period?
  • Give out the full form of AMA?
  • Define bilateral procedure?
  • What is the definition for medi-pass number?
  • Difference between premium and deductible?
  • Distinguish between Non-covered and not-covered service?
  • What according to you is the objective of MCO?
  • What is the assignment of benefits?
  • What is the full form of EOMB?
  • What do you say about accept assignment?
  • What do you know about ABN form?
  • Distinguish between Inclusive and also Bundled procedure?
  • Brief about (UPIN #) and how many characters involved in it?
  • Define the pre-existing condition?
  • What do you know about copay?
  • Tell me about advantages and the disadvantages of HMO, PPO plans?

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