Question 1

A request for a Medicare administrative law judge hearing can be made if the amount in controversy is at least

Accepted Answer

A)  $130. 
B)  $250. 
C)  $350. 
D)  $500. 
A)  $130. 
B)  $250. 
C)  $350. 
D)  $500. A

Question 2

FTC stands for _________________________.

Accepted Answer

Federal Trade Commission

Question 3

Monitoring the activities of insurance companies and making sure that the interests of the policyholders are protected are the jobs of the insurance ____________________.

Accepted Answer

commission

Question 4

A delinquent insurance claim may be easily located by reviewing the _________________________.

Accepted Answer

insurance

Question 5

Which statement is true of the insurance commission of the state?

Accepted Answer

A)  To maintain all complaints confidential every year. 
B)  To make sure that all organizations authorized to transact insurance including agents and brokers are in compliance with the insurance laws of that state. 
C)  To bring insurance claim submissions to court when there are disputes about payments. 
D)  To monitor activities of policyholders and to ensure the interests of insurance companies. 
A)  To maintain all complaints confidential every year. 
B)  To make sure that all organizations authorized to transact insurance including agents and brokers are in compliance with the insurance laws of that state. 
C)  To bring insurance claim submissions to court when there are disputes about payments. 
D)  To monitor activities of policyholders and to ensure the interests of insurance companies.

Question 6

If an insured is in disagreement with the insurer for settlement of a claim, a suit must begin within

Accepted Answer

A)  1 year. 
B)  2 years. 
C)  3 years. 
D)  5 years. 
A)  1 year. 
B)  2 years. 
C)  3 years. 
D)  5 years.

Question 7

A Level 1 Medicare redetermination (appeal) may be made by telephone, in writing, or by submitting a CMS-20027 form.

Accepted Answer

A) True 
 B)False

Question 8

The highest level of a Medicare redetermination is with an administrative law judge hearing.

Accepted Answer

A) True 
 B)False

Question 9

The total number of levels of redetermination that exist in the Medicare program is

Accepted Answer

A)  two. 
B)  three. 
C)  five. 
D)  six. 
A)  two. 
B)  three. 
C)  five. 
D)  six.

Question 10

The following are examples of problem claim filing EXCEPT:

Accepted Answer

A)  payment paid to patient. 
B)  payment lost in the mail. 
C)  denied for no preauthorization. 
D)  all are examples of problem claim filing. 
A)  payment paid to patient. 
B)  payment lost in the mail. 
C)  denied for no preauthorization. 
D)  all are examples of problem claim filing.

Question 11

An insurance claim for which prior approval was not obtained would be

Accepted Answer

A)  paid. 
B)  unauthorized. 
C)  suspended. 
D)  denied. 
A)  paid. 
B)  unauthorized. 
C)  suspended. 
D)  denied.

Question 12

When downcoding occurs, payment will

Accepted Answer

A)  not be affected. 
B)  be denied. 
C)  be less. 
D)  be more. 
A)  not be affected. 
B)  be denied. 
C)  be less. 
D)  be more.

Question 13

Overdue payment on an insurance claim is referred to as ____________________.

Accepted Answer

The answer of Overdue payment on an insurance claim is...

Question 14

What should you do if an insurance carrier requests information about another insurance carrier?

Accepted Answer

A)  Provide the information. 
B)  Call the patient and advise him or her to contact the insurance carrier with the requested information. 
C)  The carrier should contact the other carrier and coordinate benefits. 
D)  None of the above. 
A)  Provide the information. 
B)  Call the patient and advise him or her to contact the insurance carrier with the requested information. 
C)  The carrier should contact the other carrier and coordinate benefits. 
D)  None of the above.

Question 15

Insurance companies are rated according to the number of complaints received about them.

Accepted Answer

A) True 
 B)False

Question 16

An insurance claim that is processed without following specific insurance carrier instructions is considered a/an ____________________ claim.

Accepted Answer

The answer of An insurance claim that is processed without...

Question 17

If the medical practice receives payment from an insurance company that is more than the contract rate, it is called a/an ____________________.

Accepted Answer

The answer of If the medical practice receives payment from...

Question 18

The explanation of benefits (EOB), which details the amount allowable, the amount that needs to be adjusted, and the reason why, is issued by the health insurance company.

Accepted Answer

A) True 
 B)False

Question 19

The patient's health insurance card specifies all benefits and coverages.

Accepted Answer

A) True 
 B)False

Question 20

A rejected insurance claim should be corrected and sent for review or appeal.

Accepted Answer

A) True 
 B)False

A request for a Medicare administrative law judge hearing can be made if the amount in controversy is at least

FTC stands for _________________________.

Monitoring the activities of insurance companies and making sure that the interests of the policyholders are protected are the jobs of the insurance ____________________.

A delinquent insurance claim may be easily located by reviewing the _________________________.

Which statement is true of the insurance commission of the state?

If an insured is in disagreement with the insurer for settlement of a claim, a suit must begin within

A Level 1 Medicare redetermination (appeal) may be made by telephone, in writing, or by submitting a CMS-20027 form.

The highest level of a Medicare redetermination is with an administrative law judge hearing.

The total number of levels of redetermination that exist in the Medicare program is

The following are examples of problem claim filing EXCEPT:

An insurance claim for which prior approval was not obtained would be

When downcoding occurs, payment will

Overdue payment on an insurance claim is referred to as ____________________.

What should you do if an insurance carrier requests information about another insurance carrier?

Insurance companies are rated according to the number of complaints received about them.

An insurance claim that is processed without following specific insurance carrier instructions is considered a/an ____________________ claim.

If the medical practice receives payment from an insurance company that is more than the contract rate, it is called a/an ____________________.

The explanation of benefits (EOB), which details the amount allowable, the amount that needs to be adjusted, and the reason why, is issued by the health insurance company.

The patient's health insurance card specifies all benefits and coverages.

A rejected insurance claim should be corrected and sent for review or appeal.

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

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 9: Receiving Payments and Insurance Problem Solving

A request for a Medicare administrative law judge hearing can be made if the amount in controversy is at least

FTC stands for _________________________.

Monitoring the activities of insurance companies and making sure that the interests of the policyholders are protected are the jobs of the insurance ____________________.

A delinquent insurance claim may be easily located by reviewing the _________________________.

Which statement is true of the insurance commission of the state?

If an insured is in disagreement with the insurer for settlement of a claim, a suit must begin within

A Level 1 Medicare redetermination (appeal) may be made by telephone, in writing, or by submitting a CMS-20027 form.

The highest level of a Medicare redetermination is with an administrative law judge hearing.

The total number of levels of redetermination that exist in the Medicare program is

The following are examples of problem claim filing EXCEPT:

An insurance claim for which prior approval was not obtained would be

When downcoding occurs, payment will

Overdue payment on an insurance claim is referred to as ____________________.

What should you do if an insurance carrier requests information about another insurance carrier?

Insurance companies are rated according to the number of complaints received about them.

An insurance claim that is processed without following specific insurance carrier instructions is considered a/an ____________________ claim.

If the medical practice receives payment from an insurance company that is more than the contract rate, it is called a/an ____________________.

The explanation of benefits (EOB), which details the amount allowable, the amount that needs to be adjusted, and the reason why, is issued by the health insurance company.

The patient's health insurance card specifies all benefits and coverages.

A rejected insurance claim should be corrected and sent for review or appeal.

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

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