Question 1

What health insurance plan may employees of the federal government select?

Accepted Answer

A)  Flexible Blue plan 
B)  Federal Employee Health Benefits (FEH
B)  plan 
C)  Blue Protection plan 
D)  None federal government employees are not eligible 
A)  Flexible Blue plan 
B)  Federal Employee Health Benefits (FEH
B)  plan 
C)  Blue Protection plan 
D)  None federal government employees are not eligible B

Question 2

Why is insurance always verified?

Accepted Answer

A)  to ensure the insurance company gets a discount 
B)  to ensure the physician gets a discount 
C)  to ensure the patient gets a discount 
D)  to be sure that the patient is eligible for services 
A)  to ensure the insurance company gets a discount 
B)  to ensure the physician gets a discount 
C)  to ensure the patient gets a discount 
D)  to be sure that the patient is eligible for services D

Question 3

The BCBS Blue Card program provides benefits for subscribers who are away from their _____.

Accepted Answer

A)  local areas 
B)  primary care providers 
C)  families 
D)  region 
A)  local areas 
B)  primary care providers 
C)  families 
D)  region A

Question 4

Who sends the claim to the BlueCross and BlueShield when the provider does not participate?

Accepted Answer

A)  the PPN 
B)  the provider 
C)  the patient 
D)  the employer 
A)  the PPN 
B)  the provider 
C)  the patient 
D)  the employer

Question 5

_____ is BCBS plan in the subscriber's community.

Accepted Answer

A)  home plan 
B)  domestic plan 
C)  household plan 
D)  internal plan 
A)  home plan 
B)  domestic plan 
C)  household plan 
D)  internal plan

Question 6

____ has a full range of products, including health care, dental, pharmacy, group life, behavioral health, disability and long-term care benefits and has more than 44 million members.

Accepted Answer

A)  HealthKeepers 
B)  State Farm 
C)  Aetna 
D)  Allstate 
A)  HealthKeepers 
B)  State Farm 
C)  Aetna 
D)  Allstate

Question 7

______ links participating providers and independent BCBS plans throughout the nation with a single electronic claim processing and reimbursement system.

Accepted Answer

A)  BlueCard Program 
B)  Subcontract Program 
C)  Outsource Program 
D)  BlueCross Program 
A)  BlueCard Program 
B)  Subcontract Program 
C)  Outsource Program 
D)  BlueCross Program

Question 8

A (n) _____ is a medical insurance plan purchased by an individual.

Accepted Answer

A)  individual health plan 
B)  unemployed family health plan 
C)  unwaged health plan 
D)  separate health plan 
A)  individual health plan 
B)  unemployed family health plan 
C)  unwaged health plan 
D)  separate health plan

Question 9

________ is the nation's largest health insurer in terms of enrollment and the largest owner of BlueCross and BlueShield plans.

Accepted Answer

A)  WellPoint 
B)  HealthKeepers 
C)  Traveler 
D)  Allstate 
A)  WellPoint 
B)  HealthKeepers 
C)  Traveler 
D)  Allstate

Question 10

FEHB is the abbreviation for _____.

Accepted Answer

A)  Federal Equality Health Benefits program 
B)  Federal Equivalence Health Benefits program 
C)  Federal Employees Health Benefits program 
D)  Federal Equal Opportunity Health Benefits program 
A)  Federal Equality Health Benefits program 
B)  Federal Equivalence Health Benefits program 
C)  Federal Employees Health Benefits program 
D)  Federal Equal Opportunity Health Benefits program

Question 11

EBSA is the abbreviation for _______.

Accepted Answer

A)  Federal Department of Insurance Benefits and Pension Administration 
B)  Federal Department of Retired Benefits and Pension Administration 
C)  Federal Department of Covered Insurance Benefits Administration 
D)  Federal Department of Labor's Pension and Welfare Benefits Administration 
A)  Federal Department of Insurance Benefits and Pension Administration 
B)  Federal Department of Retired Benefits and Pension Administration 
C)  Federal Department of Covered Insurance Benefits Administration 
D)  Federal Department of Labor's Pension and Welfare Benefits Administration

Question 12

The payer's process for determining medical necessity is called _____.

Accepted Answer

A)  exploitation review 
B)  relevance review 
C)  applicability review 
D)  utilization review 
A)  exploitation review 
B)  relevance review 
C)  applicability review 
D)  utilization review

Question 13

A (n) _____ is an individual who enrolls in a plan at a time other than the earliest possible enrollment date or a special enrollment date.

Accepted Answer

A)  late enrollee 
B)  uninsured enrollee 
C)  overdue enrollee 
D)  belated enrollee 
A)  late enrollee 
B)  uninsured enrollee 
C)  overdue enrollee 
D)  belated enrollee

Question 14

______ is a prepaid group practice that offers both health care services and insurance in one package and is the largest nonprofit HMO.

Accepted Answer

A)  Aetna 
B)  HealthKeepers 
C)  Kaiser Permanente 
D)  CIGNA 
A)  Aetna 
B)  HealthKeepers 
C)  Kaiser Permanente 
D)  CIGNA

Question 15

_____ is a managed care program where physicians and other health care providers sign participation contracts agreeing to accept reduced fees in exchange for membership in the network.

Accepted Answer

A)  HMO 
B)  AARP 
C)  PPO 
D)  POS 
A)  HMO 
B)  AARP 
C)  PPO 
D)  POS

Question 16

______ is BCBS consumer-driven health plan that combines a comprehensive PPO plan with an HSA, an HRA, or an FSA.

Accepted Answer

A)  Bendable Blue 
B)  Flexible Blue 
C)  Plaint Blue 
D)  Compliant 
A)  Bendable Blue 
B)  Flexible Blue 
C)  Plaint Blue 
D)  Compliant

Question 17

_______ gives an employee who is leaving a job the right to continue health coverage under the employers' plan for a limited time at his or her own expense.

Accepted Answer

A)  COBRA 
B)  Terminated Employee Insurance 
C)  BRACO 
D)  AARP 
A)  COBRA 
B)  Terminated Employee Insurance 
C)  BRACO 
D)  AARP

Question 18

BCBS is the abbreviation for the _____.

Accepted Answer

A)  BlueCross BlueShield Association 
B)  BlueKeepers BlueShield Association 
C)  BlueKeepers BlackShield Association 
D)  BlackCross BlackShield Association 
A)  BlueCross BlueShield Association 
B)  BlueKeepers BlueShield Association 
C)  BlueKeepers BlackShield Association 
D)  BlackCross BlackShield Association

Question 19

The BlueCross and BlueShield Association (BCBS) is a group of ______.

Accepted Answer

A)  physicians 
B)  independent companies and a federal employee program 
C)  patients 
D)  government officials 
A)  physicians 
B)  independent companies and a federal employee program 
C)  patients 
D)  government officials

Question 20

A (n) ____ is a fixed amount that must be met periodically by each individual of an insured/dependent group.

Accepted Answer

A)  individual deductible 
B)  group deductible 
C)  separate deductible 
D)  family deductible 
A)  individual deductible 
B)  group deductible 
C)  separate deductible 
D)  family deductible

What health insurance plan may employees of the federal government select?

Why is insurance always verified?

The BCBS Blue Card program provides benefits for subscribers who are away from their _____.

Who sends the claim to the BlueCross and BlueShield when the provider does not participate?

_____ is BCBS plan in the subscriber's community.

____ has a full range of products, including health care, dental, pharmacy, group life, behavioral health, disability and long-term care benefits and has more than 44 million members.

______ links participating providers and independent BCBS plans throughout the nation with a single electronic claim processing and reimbursement system.

A (n) _____ is a medical insurance plan purchased by an individual.

________ is the nation's largest health insurer in terms of enrollment and the largest owner of BlueCross and BlueShield plans.

FEHB is the abbreviation for _____.

EBSA is the abbreviation for _______.

The payer's process for determining medical necessity is called _____.

A (n) _____ is an individual who enrolls in a plan at a time other than the earliest possible enrollment date or a special enrollment date.

______ is a prepaid group practice that offers both health care services and insurance in one package and is the largest nonprofit HMO.

_____ is a managed care program where physicians and other health care providers sign participation contracts agreeing to accept reduced fees in exchange for membership in the network.

______ is BCBS consumer-driven health plan that combines a comprehensive PPO plan with an HSA, an HRA, or an FSA.

_______ gives an employee who is leaving a job the right to continue health coverage under the employers' plan for a limited time at his or her own expense.

BCBS is the abbreviation for the _____.

The BlueCross and BlueShield Association (BCBS) is a group of ______.

A (n) ____ is a fixed amount that must be met periodically by each individual of an insured/dependent group.

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters

Exam 8: Private Payersblue Cross and Blue Shield

What health insurance plan may employees of the federal government select?

Why is insurance always verified?

The BCBS Blue Card program provides benefits for subscribers who are away from their _____.

Who sends the claim to the BlueCross and BlueShield when the provider does not participate?

_____ is BCBS plan in the subscriber's community.

____ has a full range of products, including health care, dental, pharmacy, group life, behavioral health, disability and long-term care benefits and has more than 44 million members.

______ links participating providers and independent BCBS plans throughout the nation with a single electronic claim processing and reimbursement system.

A (n) _____ is a medical insurance plan purchased by an individual.

________ is the nation's largest health insurer in terms of enrollment and the largest owner of BlueCross and BlueShield plans.

FEHB is the abbreviation for _____.

EBSA is the abbreviation for _______.

The payer's process for determining medical necessity is called _____.

A (n) _____ is an individual who enrolls in a plan at a time other than the earliest possible enrollment date or a special enrollment date.

______ is a prepaid group practice that offers both health care services and insurance in one package and is the largest nonprofit HMO.

_____ is a managed care program where physicians and other health care providers sign participation contracts agreeing to accept reduced fees in exchange for membership in the network.

______ is BCBS consumer-driven health plan that combines a comprehensive PPO plan with an HSA, an HRA, or an FSA.

_______ gives an employee who is leaving a job the right to continue health coverage under the employers' plan for a limited time at his or her own expense.

BCBS is the abbreviation for the _____.

The BlueCross and BlueShield Association (BCBS) is a group of ______.

A (n) ____ is a fixed amount that must be met periodically by each individual of an insured/dependent group.

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Health Care Claim Preparation and Transmission

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters