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Medical Insurance and Billing Questions - All Grades

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Continuing Education Medical Insurance and Billing
                is a standard fee based on the type of insurance you have and is usually due at the time of service.
  1. Coinsurance
  2. Deductibles
  3. Co-pay
  4. Premiums
Continuing Education Medical Insurance and Billing
                is a fixed % of the allowed amount for a covered item or service that the insured must contribute
  1. Co-pay
  2. Coinsurance
  3. Deductible
  4. Premium
Continuing Education Medical Insurance and Billing
Which managed care type REQUIRES the insured to select a Primary Care Provider (PCP)?
  1. EPO
  2. PPO
  3. HMO
  4. POS
Continuing Education Medical Insurance and Billing
This type of insurance can be purchased directly or through an employer.
  1. Public Insurance
  2. EPO
  3. Managed Care
  4. Private Insurance
Continuing Education Medical Insurance and Billing
What is the fixed amount of money the customer has to pay before most, if not all, of the policy's benefits can be used?
  1. Coinsurance
  2. Co-pay
  3. Deductible
  4. Premium
College Medical Insurance and Billing
Medicare part A is known as:
  1. Supplementary Medical Insurance
  2. Hospice Insurance
  3. Hospital coverage
  4. Outpatient coverage
Continuing Education Medical Insurance and Billing
What three elements apply to all health plans?
  1. Age, Income & Pricing Region
  2. Premiums, Individual Mandate, Cost - Sharing Reductions
  3. Out of Pocket Costs, Premium Costs & Covered Services
  4. Silver, Bronze and Gold Tiers
College Medical Insurance and Billing
Medicare part B is known as:
  1. Outpatient coverage
  2. Hospice Insurance
  3. Hospital coverage
  4. Prescription drug coverage
Continuing Education Medical Insurance and Billing
The Affordable Care Act (ACA) is a US law that was passed March 23, 2010 and went into effect when?
  1. October 2013
  2. January 2014
  3. December 2013
Continuing Education Medical Insurance and Billing
Union plans and COBRA plans count as minimum essential coverage.
  1. True
  2. False
College Medical Insurance and Billing
HIPAA has brought forth electronic formats for determination of eligibility for a health insurance plan.
  1. True
  2. False
College Medical Insurance and Billing
HIPAA requires that the NPI number be used to identify employers rather than inputting the actual name of the company when submitting claims.
  1. True
  2. False
College Medical Insurance and Billing
A public or private agency primarily engaged in providing pain relief, symptom management, and supportive services to terminally ill patients and their families in their own homes or in a homelike center.
  1. Formulary
  2. Respite Care
  3. Hospice
  4. Advance Beneficiary
College Medical Insurance and Billing
When a patient has declared bankruptcy, it is permissible to continue to send monthly statements for a balance due.
  1. True
  2. False
College Medical Insurance and Billing
Most state collection laws allow telephone calls to the debtor between 8 AM and 9 PM.
  1. True
  2. False
College Medical Insurance and Billing
A decision to appeal a claim should be based on whether there is sufficient data to back up the claim and if there is a large amount of money in question.
  1. True
  2. False
College Medical Insurance and Billing
In the Medicare reconsideration Level 2 process, the request must be within 9 months from the date of the original determination shown on the remittance advice.
  1. True
  2. False
College Medical Insurance and Billing
If the provider has no contract with the insurance carrier, the provider is not obligated to the carrier’s deadline.
  1. True
  2. False
College Medical Insurance and Billing
A written request made to an insurance company to locate the status of an insurance claim is often referred to as:
  1. tracer
  2. inquiry
  3. follow-up
  4. all of the above
College Medical Insurance and Billing
An overpayment is receipt of less than the contract rate from a managed care plan for a patient who has received medical services.
  1. True
  2. False
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