health insurance ch1

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Author:
dbkqn
ID:
81401
Filename:
health insurance ch1
Updated:
2011-04-24 10:38:07
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health insurance chaapter one ch1 HI
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Description:
CHAPTER ONE FOR MR C'S CLASS
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  1. The document submitted to the payer requesting reimbursement is called a(n)

    a) explanation of benefits
    b) health insurance claim
    c) remittance advice
    d) preauthorization form
    • a) explanation of benefits
    • b) health insurance claim
    • c) remittance advice
    • d) preauthorization form
  2. The Centers for Medicare and Medicaid Services (CMS) is an administration within the

    a) Administration for Children and Families
    b) Department of Health and Human Services
    c) Food and Drug Administration
    d) Office of the Inspector General
    • a) Administration for Children and Families
    • b) Department of Health and Human Services
    • c) Food and Drug Administration
    • d) Office of the Inspector General
  3. A healthcare practitiooner is also called a

    a) dealer
    b) provider
    c)purveyor
    d) supplier
    • a) dealer
    • b) provider
    • c)purveyor
    • d) supplier
  4. Which is the most appropriate response to a patient who calls the office and asks to speak with the physician?

    a) Politely state that the physician is busy and cannot be disturbed
    b) Explain that the physician is with a patient, and ask if the patient would leave a message.
    c) Transfer the call to the exam room where the physiciaan is located.
    d) Offer to schedule an appointment for the patent to be seen by the physician.
    • a) Politely state that the physician is busy and cannot be disturbed
    • b) Explain that the physician is with a patient, and ask if the patient would leave a message.
    • c) Transfer the call to the exam room where the physiciaan is located.
    • d) Offer to schedule an appointment for the patent to be seen by the physician.
  5. The process of assigning diagnoses, procedures, and services using numeric and aalphanumeric characters is called

    a) coding
    b) data processing
    c) programming
    d) reimbursement
    • a) coding
    • b) data processing
    • c) programming
    • d) reimbursment
  6. If a health insurance plan's preatuthorization requirements are not met by providers,

    a) administrative costs are reduced
    b) patients' coverage is cancelled
    c) payment of the claim is denied
    d) they pay a fine to the health plan
    • a) administrative costs are reduced
    • b) patients' coverage is cancelled
    • c) payment of the claim is denied
    • d) they pay a fine to the health plan
  7. Which coding system is used to report diagnoses and conditions on claims?

    a)CPT
    b) HCPCS
    c) ICD
    d) national codes
    • a)CPT
    • b) HCPCS
    • c) ICD
    • d) national codes
  8. The CPT coding system is published by the

    a) ADA
    b) AHMA
    c) AMA
    d) CMS
    • a) ADA
    • b) AHMA
    • c) AMA
    • d) CMS
  9. National codes are associated with

    a) CDT
    b) CPT
    c) HCPCS
    d) ICD
    • a) CDT
    • b) CPT
    • c) HCPCS
    • d) ICD
  10. Which report is sent to the patient by the payer to clarify the results of claims processing?

    a) explanation of benefits
    b) health insurance claim
    c) preauthorization form
    d) remittance advice
    • a) explanation of benefits
    • b) health insurance claim
    • c) preauthorization form
    • d) remittance advice
  11. A remittance advice contains

    a) payment information about a claim
    b) provider qualifications and reponsibilities
    c) detected errors and omissions from claims
    d) documentation of medical necessity
    • a) payment information about a claim
    • b) provider qualifications and reponsibilities
    • c) detected errors and omissions from claims
    • d) documentation of medical necessity
  12. Which type of insurance guarantees repayment for financial losses resulting from an employee's act or failure to act

    a) bonding
    b) liability
    c) property
    d) workers compensation
    • a) bonding
    • b) liability
    • c) property
    • d) workers compensation
  13. Medical malpractice insurance is a type of __________ insurance

    a) bonding
    b) liability
    c) property
    d) workers' compensation
    • a) bonding
    • b) liability
    • c) property
    • d) workers' compensation
  14. Which mandates workers' compensation insurance to cover employees and their dependants against injury and death occurring during the course of employment?

    a) state
    b) federal
    c) local
    d) workers' compensation coverage is optional
    • a) state
    • b) federal
    • c) local
    • d) workers' compensation coverage is optional
  15. The American Medical Billing Association offers which cerification exam?

    a) CCS
    b) CMRS
    c) CPC
    d) RHIT
    • a) CCS
    • b) CMRS
    • c) CPC
    • d) RHIT

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