Question 1

Which of the following is a type of insurance coverage for persons injured on the job?

Accepted Answer

A) Major medical 
B) Managed care 
C) Workers' Compensation 
D) Self-insurance 
A) Major medical 
B) Managed care 
C) Workers' Compensation 
D) Self-insurance C

Question 2

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

-capitation payment

Accepted Answer

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

Question 3

When a person has both Medicare and Medicaid insurance, charges are submitted first to:

Accepted Answer

A) Medicare, then last to Medicaid 
B) Medicaid only 
C) Medicaid, then to Medicare 
D) You can not have both Medicare and Medicaid insurances at the same time 
A) Medicare, then last to Medicaid 
B) Medicaid only 
C) Medicaid, then to Medicare 
D) You can not have both Medicare and Medicaid insurances at the same time A

Question 4

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 5

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 6

Which of the following best describes insurance policies that require policyholders to select a primary care provider?

Accepted Answer

A) Traditional 
B) Group 
C) Major medical 
D) Indemnity 
A) Traditional 
B) Group 
C) Major medical 
D) Indemnity

Question 7

Before certain procedures or visits can be made, some insurance policies require which of the following?

Accepted Answer

A) Preauthorization 
B) Predetermination 
C) Preregistration 
D) Claim review 
A) Preauthorization 
B) Predetermination 
C) Preregistration 
D) Claim review

Question 8

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 9

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 10

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

Question 11

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 12

An insurance identification card contains the insured person's name, ID number, group number and what other information?

Accepted Answer

A) telephone number 
B) social security number 
C) co-pay amount 
D) employers name 
A) telephone number 
B) social security number 
C) co-pay amount 
D) employers name

Question 13

Which of the following applies to Medicare coverage that pays for outpatient services?

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 14

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 15

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

Question 16

Which of the following is NOT a category for referrals?

Accepted Answer

A) Post-dated 
B) Regular 
C) Urgent 
D) STAT 
A) Post-dated 
B) Regular 
C) Urgent 
D) STAT

Question 17

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 18

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 19

Which of the following best describes policies that are supplementary to Medicare insurance?

Accepted Answer

A) Interim 
B) Medicaid 
C) TRICARE 
D) Medigap 
A) Interim 
B) Medicaid 
C) TRICARE 
D) Medigap

Question 20

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

Exam 16: Medical Insurance

Which of the following is a type of insurance coverage for persons injured on the job?

Indicate whether the statements apply to managed care or traditional insurance plans. -capitation payment

When a person has both Medicare and Medicaid insurance, charges are submitted first to:

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

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

Which of the following best describes insurance policies that require policyholders to select a primary care provider?

Before certain procedures or visits can be made, some insurance policies require which of the following?

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

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

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

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?

An insurance identification card contains the insured person's name, ID number, group number and what other information?

Which of the following applies to Medicare coverage that pays for outpatient services?

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

Health insurance was designed for what reason?

Which of the following is NOT a category for referrals?

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

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 best describes policies that are supplementary to Medicare insurance?

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

The Medical Assisting Profession

Health Care Settings and the Health Care Team

Coping Skills for the Medical Assistant

Therapeutic Communication Skills

The Therapeutic Approach to the Patient With a Life-Threatening Illness

Legal Considerations

Ethical Considerations

Emergency Procedures and First Aid

Creating the Facility Environment

Computers in the Medical Clinic

Telecommunications

Patient Scheduling

Medical Records Management

Written Communications

Medical Documents

Medical Coding

Daily Financial Practices

Billing and Collections

Accounting Practices

Infection Control and Medical Asepsis

The Patient History and Documentation

Vital Signs and Measurements

The Physical Examination

Obstetrics and Gynecology

Pediatrics

Male Reproductive System

Gerontology

Examinations and Procedures of Body Systems

Assisting With Minor Surgery

Diagnostic Imaging

Rehabilitation and Therapeutic Modalities

Nutrition in Health and Disease

Basic Pharmacology

Calculation of Medication Dosage and Medication Administration

Cardiac Procedures

Regulatory Guidelines for Safety and Quality in the Medical Laboratory

Introduction to the Medical Laboratory

Phlebotomy: Venipuncture and Capillary Puncture

Hematology

Urinalysis

Basic Microbiology

Speciality Laboratory Tests

The Medical Assistant As Clinic Manager

The Medical Assistant As Human Resources Manager

Preparing for Medical Assisting Credentials

Employment Strategies

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