Question 1

OSHA stands for the:

Accepted Answer

A)  Occupational Standards for Health Administration. 
B)  Optional Safety and Health Act. 
C)  Occupational Safety and Health Administration. 
D)  Optional Standards for Health Act. 
A)  Occupational Standards for Health Administration. 
B)  Optional Safety and Health Act. 
C)  Occupational Safety and Health Administration. 
D)  Optional Standards for Health Act.

Question 2

Each ________ regulates and administers its own workers' compensation program.

Accepted Answer

The answer of Each ________ regulates and administers its own...

Question 3

The prospective approval of healthcare based solely on medical necessity is called:

Accepted Answer

A)  preapproval. 
B)  prior approval. 
C)  preauthorization. 
D)  precertification. 
A)  preapproval. 
B)  prior approval. 
C)  preauthorization. 
D)  precertification.

Question 4

Workers' compensation death benefits paid when a worker has died as a result of an on-the-job injury are paid to the employee's:

Accepted Answer

A)  designated beneficiary. 
B)  children under age 18 only. 
C)  spouse only. 
D)  spouse and dependent children. 
A)  designated beneficiary. 
B)  children under age 18 only. 
C)  spouse only. 
D)  spouse and dependent children.

Question 5

Match the following
-Government program that provides income benefits to people who cannot work because of a medical condition lasting 1 year or more

Accepted Answer

A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding 
A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding

Question 6

A Work Status Report must be sent in with the insurance claim each time the injured worker is seen by the treating doctor.

Accepted Answer

A) True 
 B)False

Question 7

________ reimburse a covered individual for lost wages that occur because of a disability that prevents the individual from working.

Accepted Answer

Disability

Question 8

A Notice of Workers' Compensation Coverage must include the:

Accepted Answer

A)  workers' compensation insurance administrator's name. 
B)  workers' compensation insurance administrator's address. 
C)  Workers' compensation insurance administrator's phone number. 
D)  all of the above. 
A)  workers' compensation insurance administrator's name. 
B)  workers' compensation insurance administrator's address. 
C)  Workers' compensation insurance administrator's phone number. 
D)  all of the above.

Question 9

Match the following
-Law that provides benefits to eligible and former employees of the U.S. Department of Energy, its contractors and subcontractors, and/or to certain survivors of such individuals.

Accepted Answer

A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding 
A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding

Question 10

If an individual has both an employer-sponsored disability plan and a government-sponsored plan:

Accepted Answer

A)  the government plan is primary, and the employer plan would supplement the benefits. 
B)  the employer plan is primary, and the government plan would supplement the benefits. 
C)  only the employer plan would pay benefits. 
D)  only the government plan would pay benefits. 
A)  the government plan is primary, and the employer plan would supplement the benefits. 
B)  the employer plan is primary, and the government plan would supplement the benefits. 
C)  only the employer plan would pay benefits. 
D)  only the government plan would pay benefits.

Question 11

All of the following are medical provider fraud schemes EXCEPT:

Accepted Answer

A)  creative diagnoses. 
B)  upcoding. 
C)  unbundling. 
D)  product switching. 
A)  creative diagnoses. 
B)  upcoding. 
C)  unbundling. 
D)  product switching.

Question 12

A worker may NOT receive benefits for a generally covered injury if any of the following are true EXCEPT the:

Accepted Answer

A)  injury occurred while the worker was intoxicated. 
B)  worker signed an acknowledgement of workplace hazards. 
C)  worker failed to follow safety procedures. 
D)  worker is also receiving Social Security disability benefits. 
A)  injury occurred while the worker was intoxicated. 
B)  worker signed an acknowledgement of workplace hazards. 
C)  worker failed to follow safety procedures. 
D)  worker is also receiving Social Security disability benefits.

Question 13

Match the following
-Physician does NOT provide a sufficient level of treatment because of a fixed capitation payment arrangement

Accepted Answer

A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding 
A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding

Question 14

Doctors receiving a fixed fee per patient but not providing a sufficient level of treatment are committing which type of fraud?

Accepted Answer

A)  Underutilization 
B)  Overutilization 
C)  Internal fraud 
D)  Unbundling 
A)  Underutilization 
B)  Overutilization 
C)  Internal fraud 
D)  Unbundling

Question 15

Medical benefits replace a portion of any wages a worker loses because of a work-related injury or illness.

Accepted Answer

A) True 
 B)False

Question 16

The determination made by the treating doctor that describes the degree of permanent damage done to a worker's body as a whole as the result of a job-related injury is the:

Accepted Answer

A)  degree of injury. 
B)  injury rating. 
C)  disability rating. 
D)  impairment rating. 
A)  degree of injury. 
B)  injury rating. 
C)  disability rating. 
D)  impairment rating.

Question 17

Ombudsmen can provide all of the following services EXCEPT:

Accepted Answer

A)  legal advice to the injured worker. 
B)  information to assist the injured worker in making decisions. 
C)  a presentation of facts and evidence at dispute-resolution proceedings. 
D)  information about how to appeal a dispute-resolution decision. 
A)  legal advice to the injured worker. 
B)  information to assist the injured worker in making decisions. 
C)  a presentation of facts and evidence at dispute-resolution proceedings. 
D)  information about how to appeal a dispute-resolution decision.

Question 18

Match the following
-Illegal incentives paid for patient referrals

Accepted Answer

A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding 
A)  The Energy Employees Occupational Illness Compensation Program Act 
B)  internal fraud 
C)  unbundling 
D)  underutilization 
E)  fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding

Question 19

An employee who is injured on the job, requires treatment, and is able to return to work within several days is categorized as having an injury:

Accepted Answer

A)  without disability. 
B)  with temporary disability. 
C)  with permanent disability. 
D)  requiring vocational rehabilitation. 
A)  without disability. 
B)  with temporary disability. 
C)  with permanent disability. 
D)  requiring vocational rehabilitation.

Question 20

A spouse is eligible to receive death benefits for life unless he or she remarries.

Accepted Answer

A) True 
 B)False

OSHA stands for the:

Each ________ regulates and administers its own workers' compensation program.

The prospective approval of healthcare based solely on medical necessity is called:

Workers' compensation death benefits paid when a worker has died as a result of an on-the-job injury are paid to the employee's:

Match the following -Government program that provides income benefits to people who cannot work because of a medical condition lasting 1 year or more

A Work Status Report must be sent in with the insurance claim each time the injured worker is seen by the treating doctor.

________ reimburse a covered individual for lost wages that occur because of a disability that prevents the individual from working.

A Notice of Workers' Compensation Coverage must include the:

Match the following -Law that provides benefits to eligible and former employees of the U.S. Department of Energy, its contractors and subcontractors, and/or to certain survivors of such individuals.

If an individual has both an employer-sponsored disability plan and a government-sponsored plan:

All of the following are medical provider fraud schemes EXCEPT:

A worker may NOT receive benefits for a generally covered injury if any of the following are true EXCEPT the:

Match the following -Physician does NOT provide a sufficient level of treatment because of a fixed capitation payment arrangement

Doctors receiving a fixed fee per patient but not providing a sufficient level of treatment are committing which type of fraud?

Medical benefits replace a portion of any wages a worker loses because of a work-related injury or illness.

The determination made by the treating doctor that describes the degree of permanent damage done to a worker's body as a whole as the result of a job-related injury is the:

Ombudsmen can provide all of the following services EXCEPT:

Match the following -Illegal incentives paid for patient referrals

An employee who is injured on the job, requires treatment, and is able to return to work within several days is categorized as having an injury:

A spouse is eligible to receive death benefits for life unless he or she remarries.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Filters

Exam 17: Workers Compensation

OSHA stands for the:

Each ________ regulates and administers its own workers' compensation program.

The prospective approval of healthcare based solely on medical necessity is called:

Workers' compensation death benefits paid when a worker has died as a result of an on-the-job injury are paid to the employee's:

Match the following -Government program that provides income benefits to people who cannot work because of a medical condition lasting 1 year or more

A Work Status Report must be sent in with the insurance claim each time the injured worker is seen by the treating doctor.

________ reimburse a covered individual for lost wages that occur because of a disability that prevents the individual from working.

A Notice of Workers' Compensation Coverage must include the:

Match the following -Law that provides benefits to eligible and former employees of the U.S. Department of Energy, its contractors and subcontractors, and/or to certain survivors of such individuals.

If an individual has both an employer-sponsored disability plan and a government-sponsored plan:

All of the following are medical provider fraud schemes EXCEPT:

A worker may NOT receive benefits for a generally covered injury if any of the following are true EXCEPT the:

Match the following -Physician does NOT provide a sufficient level of treatment because of a fixed capitation payment arrangement

Doctors receiving a fixed fee per patient but not providing a sufficient level of treatment are committing which type of fraud?

Medical benefits replace a portion of any wages a worker loses because of a work-related injury or illness.

The determination made by the treating doctor that describes the degree of permanent damage done to a worker's body as a whole as the result of a job-related injury is the:

Ombudsmen can provide all of the following services EXCEPT:

Match the following -Illegal incentives paid for patient referrals

An employee who is injured on the job, requires treatment, and is able to return to work within several days is categorized as having an injury:

A spouse is eligible to receive death benefits for life unless he or she remarries.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Filters