Question 1

The cost-sharing amount a managed care patient must pay at the point of arriving in the office is referred to as the ________________.

Accepted Answer

The answer of The cost-sharing amount a managed care patient...

Question 2

An attachment to an insurance policy that excludes certain illnesses or disabilities that would otherwise be covered is referred to as a/an

Accepted Answer

A)  waiver. 
B)  exclusion. 
C)  grace period. 
D)  deductible. 
A)  waiver. 
B)  exclusion. 
C)  grace period. 
D)  deductible.

Question 3

Under HIPAA guidelines, physicians must send all claims electronically

Accepted Answer

A)  if they have fewer than 25 full-time employees. 
B)  if they have more than 25 full-time employees. 
C)  if they have more than 10 full-time employees. 
D)  if they have fewer than 10 full-time employees. 
A)  if they have fewer than 25 full-time employees. 
B)  if they have more than 25 full-time employees. 
C)  if they have more than 10 full-time employees. 
D)  if they have fewer than 10 full-time employees.

Question 4

An insurance policy becomes effective only after the company offers the policy and the person accepts it and then pays the initial ____________________.

Accepted Answer

The answer of An insurance policy becomes effective only after...

Question 5

Conditions that existed and were treated before the health insurance policy was issued are called

Accepted Answer

A)  accidents. 
B)  illnesses. 
C)  preexisting. 
D)  unforeseen occurrences. 
A)  accidents. 
B)  illnesses. 
C)  preexisting. 
D)  unforeseen occurrences.

Question 6

The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA), together, are commonly referred to as: ____________________________

Accepted Answer

The Afford

Question 7

Match each type of health plan to its description.

-A program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled.

Accepted Answer

A) Independent practice association (IP
A)  
B) Medicaid 
C) State disability or Unemployment Compensation Disability (UC
D)  
D) TRICARE 
E) Workers' compensation insurance
F)CHAMPVA
G)Health maintenance organization (HMO)
H)Disability income insurance
I)Medicare 
A) Independent practice association (IP
A)  
B) Medicaid 
C) State disability or Unemployment Compensation Disability (UC
D)  
D) TRICARE 
E) Workers' compensation insurance
F)CHAMPVA
G)Health maintenance organization (HMO)
H)Disability income insurance
I)Medicare

Question 8

Under the Medicare program, the individual is required to assume a percentage of the fee (20%) for covered services, which is referred to as cost sharing.

Accepted Answer

A) True 
 B)False

Question 9

What is the minimum number of employees a company must have to meet the criteria of the COBRA for continued medical benefits if an employee is laid off from a company?

Accepted Answer

A)  15 
B)  20 
C)  25 
D)  50 
A)  15 
B)  20 
C)  25 
D)  50

Question 10

When a patient carries private medical insurance, the contract for treatment exists between

Accepted Answer

A)  the patient and the insurance company. 
B)  the physician and the patient. 
C)  the physician and the insurance company. 
D)  the policyholder and the insurance company. 
A)  the patient and the insurance company. 
B)  the physician and the patient. 
C)  the physician and the insurance company. 
D)  the policyholder and the insurance company.

Question 11

The insured is always

Accepted Answer

A)  the patient. 
B)  the person at risk. 
C)  the individual enrollee or organization protected. 
D)  the employer. 
A)  the patient. 
B)  the person at risk. 
C)  the individual enrollee or organization protected. 
D)  the employer.

Question 12

According to the birthday law, if both the mother and the father have the same birthday

Accepted Answer

A)  the hour of birth determines who pays first. 
B)  the plan of the person who has coverage longer is the primary payer. 
C)  the plan that offers the best coverage is the primary payer. 
D)  the father's policy is the primary payer. 
A)  the hour of birth determines who pays first. 
B)  the plan of the person who has coverage longer is the primary payer. 
C)  the plan that offers the best coverage is the primary payer. 
D)  the father's policy is the primary payer.

Question 13

A financial accounting record that is maintained for each patient who receives professional services is referred to as a/an ____________________.

Accepted Answer

The answer of A financial accounting record that is maintained...

Question 14

An insurance billing specialist can escape liability by pleading ignorance.

Accepted Answer

A) True 
 B)False

Question 15

When does the physician/patient contract begin?

Accepted Answer

A)  After the physician has examined the patient for the first time 
B)  When the patient steps into the examination room to be treated 
C)  When the physician accepts the patient and agrees to treat the patient 
D)  When the patient verbally agrees to accept the advice of the physician 
A)  After the physician has examined the patient for the first time 
B)  When the patient steps into the examination room to be treated 
C)  When the physician accepts the patient and agrees to treat the patient 
D)  When the patient verbally agrees to accept the advice of the physician

Question 16

Medicare is a program jointly sponsored by federal and state governments for those eligible for public assistance.

Accepted Answer

A) True 
 B)False

Question 17

In health insurance, the insured is also known as

Accepted Answer

A)  the subscriber. 
B)  the member. 
C)  the policyholder. 
D)  all of the above. 
A)  the subscriber. 
B)  the member. 
C)  the policyholder. 
D)  all of the above.

Question 18

Under the health care reform legislation of 2010, health plans must allow employees to keep their children on their plans until the child is 26 years old.

Accepted Answer

A) True 
 B)False

Question 19

Personal insurance is usually less expensive than other health insurance.

Accepted Answer

A) True 
 B)False

Question 20

A form of health insurance that provides periodic payments to replace income when the insured is unable to work is: __________________________

Accepted Answer

Disability

The cost-sharing amount a managed care patient must pay at the point of arriving in the office is referred to as the ________________.

An attachment to an insurance policy that excludes certain illnesses or disabilities that would otherwise be covered is referred to as a/an

Under HIPAA guidelines, physicians must send all claims electronically

An insurance policy becomes effective only after the company offers the policy and the person accepts it and then pays the initial ____________________.

Conditions that existed and were treated before the health insurance policy was issued are called

The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA), together, are commonly referred to as: ____________________________

Match each type of health plan to its description. -A program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled.

Under the Medicare program, the individual is required to assume a percentage of the fee (20%) for covered services, which is referred to as cost sharing.

What is the minimum number of employees a company must have to meet the criteria of the COBRA for continued medical benefits if an employee is laid off from a company?

When a patient carries private medical insurance, the contract for treatment exists between

The insured is always

According to the birthday law, if both the mother and the father have the same birthday

A financial accounting record that is maintained for each patient who receives professional services is referred to as a/an ____________________.

An insurance billing specialist can escape liability by pleading ignorance.

When does the physician/patient contract begin?

Medicare is a program jointly sponsored by federal and state governments for those eligible for public assistance.

In health insurance, the insured is also known as

Under the health care reform legislation of 2010, health plans must allow employees to keep their children on their plans until the child is 26 years old.

Personal insurance is usually less expensive than other health insurance.

A form of health insurance that provides periodic payments to replace income when the insured is unable to work is: __________________________

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters

Exam 3: Basics of Health Insurance

The cost-sharing amount a managed care patient must pay at the point of arriving in the office is referred to as the ________________.

An attachment to an insurance policy that excludes certain illnesses or disabilities that would otherwise be covered is referred to as a/an

Under HIPAA guidelines, physicians must send all claims electronically

An insurance policy becomes effective only after the company offers the policy and the person accepts it and then pays the initial ____________________.

Conditions that existed and were treated before the health insurance policy was issued are called

The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA), together, are commonly referred to as: ____________________________

Match each type of health plan to its description. -A program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled.

Under the Medicare program, the individual is required to assume a percentage of the fee (20%) for covered services, which is referred to as cost sharing.

What is the minimum number of employees a company must have to meet the criteria of the COBRA for continued medical benefits if an employee is laid off from a company?

When a patient carries private medical insurance, the contract for treatment exists between

The insured is always

According to the birthday law, if both the mother and the father have the same birthday

A financial accounting record that is maintained for each patient who receives professional services is referred to as a/an ____________________.

An insurance billing specialist can escape liability by pleading ignorance.

When does the physician/patient contract begin?

Medicare is a program jointly sponsored by federal and state governments for those eligible for public assistance.

In health insurance, the insured is also known as

Under the health care reform legislation of 2010, health plans must allow employees to keep their children on their plans until the child is 26 years old.

Personal insurance is usually less expensive than other health insurance.

A form of health insurance that provides periodic payments to replace income when the insured is unable to work is: __________________________

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters