Question 1

Match each health insurance term with its definition.
-Term for an insurance company that reimburses for health care services

Accepted Answer

A) Advance Beneficiary Notice (ABN) 
B) carrier 
C) coordination of benefits (CO
B)  
D) fee disclosure 
E) fee schedule
F)loss-of-income benefits
G)participating provider
H)patient status
I)Relative Value Units
J)third-party payer 
A) Advance Beneficiary Notice (ABN) 
B) carrier 
C) coordination of benefits (CO
B)  
D) fee disclosure 
E) fee schedule
F)loss-of-income benefits
G)participating provider
H)patient status
I)Relative Value Units
J)third-party payer

Question 2

Match each health insurance term with its definition.
-Procedures used by insurers to avoid duplication of payment on claims when a patient has more than one policy

Accepted Answer

A) assignment of benefits 
B) TRICARE 
C) CHAMPVA 
D) coordination of benefits (CO
B)  
E) copayment
F)deductible
G)effective date
H)capitation
I)group insurance
J)health maintenance organization (HMO) 
A) assignment of benefits 
B) TRICARE 
C) CHAMPVA 
D) coordination of benefits (CO
B)  
E) copayment
F)deductible
G)effective date
H)capitation
I)group insurance
J)health maintenance organization (HMO)

Question 3

When a provider does not accept assignment from Medicare, the most that can be charged to the patient is ___ of the Medicare-approved amount.

Accepted Answer

A)  85% 
B)  100% 
C)  115% 
D)  150% 
A)  85% 
B)  100% 
C)  115% 
D)  150%

Question 4

Under workers' compensation, a patient who has an industrial injury is billed:

Accepted Answer

A)  for 20 percent of the cost of treatment 
B)  for 80 percent of the cost of treatment 
C)  for the entire cost of treatment 
D)  if treatment was given without authorization 
A)  for 20 percent of the cost of treatment 
B)  for 80 percent of the cost of treatment 
C)  for the entire cost of treatment 
D)  if treatment was given without authorization

Question 5

When a patient arrives at the medical office, you should copy _____ of the insurance card(s).

Accepted Answer

A)  only the front 
B)  only the back 
C)  both sides 
D)  neither side 
A)  only the front 
B)  only the back 
C)  both sides 
D)  neither side

Question 6

Match each health insurance term with its definition.
-Person who is insured; an insurance policy holder

Accepted Answer

A) managed care 
B) Medicaid 
C) precertification 
D) preexisting condition 
E) service area
F)subscriber
G)individual insurance
H)indemnity plan
I)utilization management (review)
J)workers' compensation 
A) managed care 
B) Medicaid 
C) precertification 
D) preexisting condition 
E) service area
F)subscriber
G)individual insurance
H)indemnity plan
I)utilization management (review)
J)workers' compensation

Question 7

Match each health insurance term with its definition.
-Approval obtained before the patient is admitted to the hospital or receives specified outpatient or in-office procedures

Accepted Answer

A) managed care 
B) Medicaid 
C) precertification 
D) preexisting condition 
E) service area
F)subscriber
G)individual insurance
H)indemnity plan
I)utilization management (review)
J)workers' compensation 
A) managed care 
B) Medicaid 
C) precertification 
D) preexisting condition 
E) service area
F)subscriber
G)individual insurance
H)indemnity plan
I)utilization management (review)
J)workers' compensation

Question 8

Match each health insurance term with its definition.
-Provider who has contracted with an insurer and accepts whatever the insurance pays as payment in full

Accepted Answer

A) Advance Beneficiary Notice (ABN) 
B) carrier 
C) coordination of benefits (CO
B)  
D) fee disclosure 
E) fee schedule
F)loss-of-income benefits
G)participating provider
H)patient status
I)Relative Value Units
J)third-party payer 
A) Advance Beneficiary Notice (ABN) 
B) carrier 
C) coordination of benefits (CO
B)  
D) fee disclosure 
E) fee schedule
F)loss-of-income benefits
G)participating provider
H)patient status
I)Relative Value Units
J)third-party payer

Question 9

Under the birthday rule, if the parents divorce and retain their plans, the parent with _____ is primary.

Accepted Answer

A)  the greater income 
B)  the plan in effect the longest 
C)  custody 
D)  the parent with the plan that provides the best coverage 
A)  the greater income 
B)  the plan in effect the longest 
C)  custody 
D)  the parent with the plan that provides the best coverage

Question 10

Part ___ of Medicare was created to provide coverage for both generic and brand name drugs.

Accepted Answer

A)  A 
B)  B 
C)  C 
D)  D 
A)  A 
B)  B 
C)  C 
D)  D

Exam 14: The Muscular System

Match each health insurance term with its definition. -Term for an insurance company that reimburses for health care services

Match each health insurance term with its definition. -Procedures used by insurers to avoid duplication of payment on claims when a patient has more than one policy

When a provider does not accept assignment from Medicare, the most that can be charged to the patient is ___ of the Medicare-approved amount.

Under workers' compensation, a patient who has an industrial injury is billed:

When a patient arrives at the medical office, you should copy _____ of the insurance card(s).

Match each health insurance term with its definition. -Person who is insured; an insurance policy holder

Match each health insurance term with its definition. -Approval obtained before the patient is admitted to the hospital or receives specified outpatient or in-office procedures

Match each health insurance term with its definition. -Provider who has contracted with an insurer and accepts whatever the insurance pays as payment in full

Under the birthday rule, if the parents divorce and retain their plans, the parent with _____ is primary.

Part ___ of Medicare was created to provide coverage for both generic and brand name drugs.

The Medical Assistant

The Health Care Team and the Medical Environment, Past and Present

Legal Issues

Ethical Issues

Verbal and Nonverbal Communications

Applying Communication Skills

Introduction to Medical Terminology

Understanding and Building Medical Terms of Body Systems

Anatomic Descriptors and Fundamental Body Structure

The Nervous System

The Senses

The Integumentary System

The Skeletal System

The Respiratory System

The Circulatory System

The Immune System

The Digestive System

The Urinary System

The Endocrine System

The Reproductive System

Telephone Communications

Written Communications

Operating Computers and Office Equipment

Scheduling Appointments and Receiving Patients

The Medical Record, Documentation, and Filing

Health Insurance

Procedural and Diagnostic Coding

Patient Accounts

Preparing Insurance Claims and Posting Insurance Payments

Patient Billing, Posting Patient Payments, and Collecting Fees

Banking Procedures

Accounts Payable and Accounting Procedures

Infection Control and Medical Asepsis

The Medical History and Patient Screening

Body Measurements and Vital Signs

Preparing for Examinations

The Physical Exam

Specialty Exams and Other Procedures

Obgyn Examinations

Pediatric Examinations

The Physicians Office Laboratory

Specimen Collection and Processing

Blood Specimen Collection

Diagnostic Testing

Cardiology Procedures

Radiology Procedures

Preparing for Surgery

Assisting With Minor Surgery

Pharmacology Fundamentals

Measurement Systems, Basic Mathematics, and Dosage Calculations

Administering Oral and Non-Injectable Medications

Administering Injections and Immunizations

Emergencies in the Medical Office and the Community

First Aid for Accidents and Injuries

Rehabilitation

Nutrition, Exercise, and Healthy Living

Practicum and the Job Search

Maintaining the Office Environment

Filters