Question 1

Large companies,non-profit organizations,and governments frequently use what kind of insurance to reduce costs and gain more control of their finances?

Accepted Answer

A)  Blue Cross/Blue Shield 
B)  HMO 
C)  Self-insurance 
D)  Workers' Compensation 
A)  Blue Cross/Blue Shield 
B)  HMO 
C)  Self-insurance 
D)  Workers' Compensation C

Question 2

MATCHING
Indicate whether the statements apply to managed care or traditional insurance plans.

-preventive treatment provided

Accepted Answer

A) managed care 
B) traditional 
A) managed care 
B) traditional A

Question 3

Health insurance was designed for what reason?

Accepted Answer

A)  To help providers increase their salary 
B)  To help individuals and families compensate for high medical costs 
C)  To ensure patients get the best care 
D)  To increase revenue for the government 
A)  To help providers increase their salary 
B)  To help individuals and families compensate for high medical costs 
C)  To ensure patients get the best care 
D)  To increase revenue for the government B

Question 4

Which of the following traditional types of insurance coverage covers specific dollar amounts for provider's fees,hospital care,and surgery?

Accepted Answer

A)  Major medical 
B)  Individual 
C)  Group 
D)  Basic 
E)  Indemnity 
A)  Major medical 
B)  Individual 
C)  Group 
D)  Basic 
E)  Indemnity

Question 5

MATCHING
Indicate whether the statements apply to managed care or traditional insurance plans.

-usually can go outside provider network

Accepted Answer

A) managed care 
B) traditional 
A) managed care 
B) traditional

Question 6

Which of the following applies to a method of containing hospital costs that is based on an average cost for treatment of a patient's condition?

Accepted Answer

A)  Capitation 
B)  Diagnostically related groups 
C)  Fee-for-service 
D)  Allowable charges 
A)  Capitation 
B)  Diagnostically related groups 
C)  Fee-for-service 
D)  Allowable charges

Question 7

Each time a patient comes to the clinic,the medical assistant must verify which of the following insurance information?

Accepted Answer

A)  Whether insurance covers the procedure 
B)  Which insurance plan does the patient have 
C)  Whether a referral is required 
D)  All of the above 
A)  Whether insurance covers the procedure 
B)  Which insurance plan does the patient have 
C)  Whether a referral is required 
D)  All of the above

Question 8

Which of the following best describes insurance policies that provide coverage on a fee-for-service basis?

Accepted Answer

A)  Traditional 
B)  Group 
C)  Managed care 
D)  Indemnity 
A)  Traditional 
B)  Group 
C)  Managed care 
D)  Indemnity

Question 9

Which of the following applies to Medicare coverage that pays for prescription drugs?

Accepted Answer

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

Question 10

Which of the following terms means an insurance policy pays a percentage of the balance after application of the deductible?

Accepted Answer

A)  Coordination of benefits 
B)  Co-insurance 
C)  Co-pay 
D)  Deductible 
E)  Birthday rule 
A)  Coordination of benefits 
B)  Co-insurance 
C)  Co-pay 
D)  Deductible 
E)  Birthday rule

Question 11

Dr.Chad is a participating provider in Medicare.Does this mean Dr.Chad will accept assignment and what percent of the allowed amount?

Accepted Answer

A)  Yes, 80% 
B)  Yes, 100% 
C)  No, 0% 
D)  None of the above 
A)  Yes, 80% 
B)  Yes, 100% 
C)  No, 0% 
D)  None of the above

Question 12

Which of the following applies to persons who are eligible for Medicare?

Accepted Answer

A)  Receive Aid to Dependent Children 
B)  Receive Supplemental Insurance Income 
C)  Receive income below the poverty level 
D)  Receive disability income 
A)  Receive Aid to Dependent Children 
B)  Receive Supplemental Insurance Income 
C)  Receive income below the poverty level 
D)  Receive disability income

Question 13

MATCHING
Indicate whether the statements apply to managed care or traditional insurance plans.

-usually must stay inside the provider network

Accepted Answer

A) managed care 
B) traditional 
A) managed care 
B) traditional

Question 14

The statement mailed to the patient summarizing how the insurance carrier determined the reimbursement is known as what?

Accepted Answer

A)  (CO
B)  coordination of benefits 
B)  (SO
B)  statement of benefits 
C)  (DO
B)  determinant of benefits 
D)  (EO
B)  explanation of benefits 
A)  (CO
B)  coordination of benefits 
B)  (SO
B)  statement of benefits 
C)  (DO
B)  determinant of benefits 
D)  (EO
B)  explanation of benefits

Question 15

Considering the amount that Medicare reimburses for medical care,what amount does the patient and Medicare pay?

Accepted Answer

A)  Patient $32; Medicare $48 
B)  Patient $32; Medicare $42 
C)  Patient $12; Medicare $48 
D)  Patient $80; Medicare $0 
A)  Patient $32; Medicare $48 
B)  Patient $32; Medicare $42 
C)  Patient $12; Medicare $48 
D)  Patient $80; Medicare $0

Question 16

Insurance fraud and abuse may be involved in more than what percentage of submitted medical claims?

Accepted Answer

A)  10% 
B)  5% 
C)  20% 
D)  50% 
A)  10% 
B)  5% 
C)  20% 
D)  50%

Question 17

Which of the following is the purpose of screening new patients for insurance coverage?

Accepted Answer

A)  To verify the patient has coverage and to obtain vital billing information. 
B)  To determine whether the physician is a provider for patient's plan. 
C)  To determine whether a referral is obtained for services. 
D)  To ensure the disease is covered by the patient's plan. 
E)  To ensure the patient understands all provisions of coverage. 
A)  To verify the patient has coverage and to obtain vital billing information. 
B)  To determine whether the physician is a provider for patient's plan. 
C)  To determine whether a referral is obtained for services. 
D)  To ensure the disease is covered by the patient's plan. 
E)  To ensure the patient understands all provisions of coverage.

Question 18

Which of the following best describes the state or regional organization that handles Medicare claims?

Accepted Answer

A)  Health maintenance organization 
B)  Social security office 
C)  Fiscal intermediary 
D)  Senior citizens' association 
A)  Health maintenance organization 
B)  Social security office 
C)  Fiscal intermediary 
D)  Senior citizens' association

Question 19

MATCHING
Indicate whether the statements apply to managed care or traditional insurance plans.

-fee-for-service payment

Accepted Answer

A) managed care 
B) traditional 
A) managed care 
B) traditional

Question 20

The amount of money that the insured must incur for medical services before the policy begins to pay is known as what?

Accepted Answer

A)  Co-insurance 
B)  Co-pay 
C)  Deductible 
D)  Coordination of benefits 
A)  Co-insurance 
B)  Co-pay 
C)  Deductible 
D)  Coordination of benefits

Exam 17: Medical Insurance

Large companies,non-profit organizations,and governments frequently use what kind of insurance to reduce costs and gain more control of their finances?

MATCHING Indicate whether the statements apply to managed care or traditional insurance plans. -preventive treatment provided

Health insurance was designed for what reason?

Which of the following traditional types of insurance coverage covers specific dollar amounts for provider's fees,hospital care,and surgery?

MATCHING Indicate whether the statements apply to managed care or traditional insurance plans. -usually can go outside provider network

Which of the following applies to a method of containing hospital costs that is based on an average cost for treatment of a patient's condition?

Each time a patient comes to the clinic,the medical assistant must verify which of the following insurance information?

Which of the following best describes insurance policies that provide coverage on a fee-for-service basis?

Which of the following applies to Medicare coverage that pays for prescription drugs?

Which of the following terms means an insurance policy pays a percentage of the balance after application of the deductible?

Dr.Chad is a participating provider in Medicare.Does this mean Dr.Chad will accept assignment and what percent of the allowed amount?

Which of the following applies to persons who are eligible for Medicare?

MATCHING Indicate whether the statements apply to managed care or traditional insurance plans. -usually must stay inside the provider network

The statement mailed to the patient summarizing how the insurance carrier determined the reimbursement is known as what?

Considering the amount that Medicare reimburses for medical care,what amount does the patient and Medicare pay?

Insurance fraud and abuse may be involved in more than what percentage of submitted medical claims?

Which of the following is the purpose of screening new patients for insurance coverage?

Which of the following best describes the state or regional organization that handles Medicare claims?

MATCHING Indicate whether the statements apply to managed care or traditional insurance plans. -fee-for-service payment

The amount of money that the insured must incur for medical services before the policy begins to pay is known as what?

The Medical Assisting Profession

Health Care Settings and the Health Care Team

History of Medicine

Coping Skills for the Medical Assistant

Therapeutic Communication Skills

The Therapeutic Approach to the Patient With Life-Threatening Illness

Legal Considerations

Ethical Considerations

Emergency Procedures and First AID

Creating the Facility Environment

Computers in the Ambulatory Care Setting

Telecommunications

Patient Scheduling

Medical Records Management

Written Communications

Medical Documents

Medical Insurance Coding

Daily Financial Practices

Billing and Collections

Accounting Practices

The Medical Assistant As Clinic Manager

The Medical Assistant As Human Resources Manager

Preparing for Medical Assisting Credentials

Employment Strategies

Filters