Question 1

Companies pay premiums for workers' compensation insurance;in return,their employees agree to:

Accepted Answer

A)  pay employers back for their insurance. 
B)  not file claims for on-the-job injuries. 
C)  split the cost of medical bills for on-the-job injuries. 
D)  give up the right to sue employers for on-the-job injuries. 
A)  pay employers back for their insurance. 
B)  not file claims for on-the-job injuries. 
C)  split the cost of medical bills for on-the-job injuries. 
D)  give up the right to sue employers for on-the-job injuries. D

Question 2

An individual responsible for investigating and resolving workers' complaints against the employer is called a/an:

Accepted Answer

A)  ombudsman. 
B)  personal claims representative. 
C)  arbitrator. 
D)  investigator. 
A)  ombudsman. 
B)  personal claims representative. 
C)  arbitrator. 
D)  investigator. A

Question 3

Name the two distinct roles of the attending physician in workers' compensation claims.

Accepted Answer

Diagnose and treat work-related injuries and illnesses
Provide claims administrators opinions in response to specific medical and legal questions about work-related injuries or illnesses

Question 4

As an alternative to traditional workers' compensation coverage,some employers choose a/an __________________ to provide medical care to injured employees.

Accepted Answer

A)  health benefit plan 
B)  employee-sponsored fund 
C)  managed care system 
D)  OSHA funded plan 
A)  health benefit plan 
B)  employee-sponsored fund 
C)  managed care system 
D)  OSHA funded plan

Question 5

Income from employment (wages)is considered:

Accepted Answer

A)  supplement income. 
B)  tax free income. 
C)  earned income. 
D)  certified income. 
A)  supplement income. 
B)  tax free income. 
C)  earned income. 
D)  certified income.

Question 6

All business organizations are required to purchase workers' compensation.

Accepted Answer

A) True 
 B)False

Question 7

List at least four of the health insurance professional's responsibilities for facilitating disability claims processing.

Accepted Answer

Obtaining the patient's authorization to

Question 8

Each state has established rules under which an employee is required to file a claim within a certain time limit.

Accepted Answer

A) True 
 B)False

Question 9

To qualify for Social Security benefits,an individual must have worked a specified number of:

Accepted Answer

A)  weeks at the same job. 
B)  years as a full-time employee. 
C)  minimum wage hours. 
D)  covered work credits. 
A)  weeks at the same job. 
B)  years as a full-time employee. 
C)  minimum wage hours. 
D)  covered work credits.

Question 10

Workers' compensation is considered a/an:

Accepted Answer

A)  fringe benefit. 
B)  optional bonus. 
C)  legally mandated right. 
D)  employee's responsibility. 
A)  fringe benefit. 
B)  optional bonus. 
C)  legally mandated right. 
D)  employee's responsibility.

Question 11

There are no work requirements for SSI,but the individual must establish:

Accepted Answer

A)  financial need. 
B)  inability to perform activities of daily living (ADL). 
C)  5 years of legal state residency. 
D)  all of the above 
A)  financial need. 
B)  inability to perform activities of daily living (ADL). 
C)  5 years of legal state residency. 
D)  all of the above

Question 12

All of the following are benefits of the workers' compensation program,except:

Accepted Answer

A)  medical expenses. 
B)  disability pay. 
C)  food and housing expenses. 
D)  death benefits. 
A)  medical expenses. 
B)  disability pay. 
C)  food and housing expenses. 
D)  death benefits.

Question 13

The health insurance professional has no tangible responsibilities in facilitating disability claims.

Accepted Answer

A) True 
 B)False

Question 14

Name the major benefit components to workers' compensation.

Accepted Answer

Medical expense pays the expenses involv

Question 15

Supplemental Security Income (SSI)and Social Security Disability Income (SSDI)are identical programs with the same requirements for enrollment.

Accepted Answer

A) True 
 B)False

Question 16

Name the five specific items the attending physician's statement must typically include when a disability claim is filed.

Accepted Answer

The diagnosis
The first day th

Question 17

Balance billing is not allowed on workers' compensation claims.

Accepted Answer

A) True 
 B)False

Question 18

Workers' compensation insurance is considered to be "no-fault insurance," which means

Accepted Answer

A)  benefits are paid regardless of who is to blame for the injury. 
B)  benefits are not paid because it is considered nobody's fault. 
C)  if it is unclear whose fault the injury is, workers' compensation does not have to pay. 
D)  the employee and employer share medical expenses. 
A)  benefits are paid regardless of who is to blame for the injury. 
B)  benefits are not paid because it is considered nobody's fault. 
C)  if it is unclear whose fault the injury is, workers' compensation does not have to pay. 
D)  the employee and employer share medical expenses.

Question 19

The condition in which the employee has reached a state of maximal medical improvement is called:

Accepted Answer

A)  chronic. 
B)  temporary. 
C)  permanent and stationary. 
D)  partial and rehabilitating. 
A)  chronic. 
B)  temporary. 
C)  permanent and stationary. 
D)  partial and rehabilitating.

Question 20

A maximum amount paid per month for short-term disability policies is called a _____ cap.

Accepted Answer

A)  short-term 
B)  maximum 
C)  disability 
D)  benefit 
A)  short-term 
B)  maximum 
C)  disability 
D)  benefit

Companies pay premiums for workers' compensation insurance;in return,their employees agree to:

An individual responsible for investigating and resolving workers' complaints against the employer is called a/an:

Name the two distinct roles of the attending physician in workers' compensation claims.

As an alternative to traditional workers' compensation coverage,some employers choose a/an __________________ to provide medical care to injured employees.

Income from employment (wages)is considered:

All business organizations are required to purchase workers' compensation.

List at least four of the health insurance professional's responsibilities for facilitating disability claims processing.

Each state has established rules under which an employee is required to file a claim within a certain time limit.

To qualify for Social Security benefits,an individual must have worked a specified number of:

Workers' compensation is considered a/an:

There are no work requirements for SSI,but the individual must establish:

All of the following are benefits of the workers' compensation program,except:

The health insurance professional has no tangible responsibilities in facilitating disability claims.

Name the major benefit components to workers' compensation.

Supplemental Security Income (SSI)and Social Security Disability Income (SSDI)are identical programs with the same requirements for enrollment.

Name the five specific items the attending physician's statement must typically include when a disability claim is filed.

Balance billing is not allowed on workers' compensation claims.

Workers' compensation insurance is considered to be "no-fault insurance," which means

The condition in which the employee has reached a state of maximal medical improvement is called:

A maximum amount paid per month for short-term disability policies is called a _____ cap.

The Origins of Health Insurance

Tools of the Trade: A Career as a Health (Medical)Insurance Professional

The Legal and Ethical Side of Medical Insurance

Types and Sources of Health Insurance

Claim Submission Methods

Traditional Fee For Service/Private Plans

Unraveling the Mysteries of Managed Care

Understanding Medicaid

Conquering Medicare’s Challenges

Military Carriers

Diagnostic Coding

Procedural, Evaluation and Management, and HCPCS Coding

The Patient

Keys to Successful Claims Management

The Role of Computers in Health Insurance

Reimbursement Procedures: Getting Paid

Hospital Billing and the UB-04

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Exam 11: Miscellaneous Carriers: Workers’ Compensation and Disability Insurance

Companies pay premiums for workers' compensation insurance;in return,their employees agree to:

An individual responsible for investigating and resolving workers' complaints against the employer is called a/an:

Name the two distinct roles of the attending physician in workers' compensation claims.

As an alternative to traditional workers' compensation coverage,some employers choose a/an __________________ to provide medical care to injured employees.

Income from employment (wages)is considered:

All business organizations are required to purchase workers' compensation.

List at least four of the health insurance professional's responsibilities for facilitating disability claims processing.

Each state has established rules under which an employee is required to file a claim within a certain time limit.

To qualify for Social Security benefits,an individual must have worked a specified number of:

Workers' compensation is considered a/an:

There are no work requirements for SSI,but the individual must establish:

All of the following are benefits of the workers' compensation program,except:

The health insurance professional has no tangible responsibilities in facilitating disability claims.

Name the major benefit components to workers' compensation.

Supplemental Security Income (SSI)and Social Security Disability Income (SSDI)are identical programs with the same requirements for enrollment.

Name the five specific items the attending physician's statement must typically include when a disability claim is filed.

Balance billing is not allowed on workers' compensation claims.

Workers' compensation insurance is considered to be "no-fault insurance," which means

The condition in which the employee has reached a state of maximal medical improvement is called:

A maximum amount paid per month for short-term disability policies is called a _____ cap.

The Origins of Health Insurance

Tools of the Trade: A Career as a Health (Medical)Insurance Professional

The Legal and Ethical Side of Medical Insurance

Types and Sources of Health Insurance

Claim Submission Methods

Traditional Fee For Service/Private Plans

Unraveling the Mysteries of Managed Care

Understanding Medicaid

Conquering Medicare’s Challenges

Military Carriers

Diagnostic Coding

Procedural, Evaluation and Management, and HCPCS Coding

The Patient

Keys to Successful Claims Management

The Role of Computers in Health Insurance

Reimbursement Procedures: Getting Paid

Hospital Billing and the UB-04

Filters