Question 1

What is the primary responsibility of an injured worker with regard to his or her employer?

Accepted Answer

The injured worker is responsible for in

Question 2

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 3

If a workers' compensation claim is denied, the provider can request a review by:
A)the state workers' compensation insurance fund.
B)the state insurance commissioner.
C)a medical examination review committee.
D)an independent review organization.

Accepted Answer

an indepen

Question 4

Match between columns
                        Premises: Physician does NOT provide a sufficient level of treatment because of a fixed capitation payment arrangement
Law that provides workers' compensation benefits to employees of the United States government
Physician orders unnecessary treatments or tests to enable billing for higher fees
Illegal incentives paid for patient referrals
Providers collude with the insurance company to defraud the employer
Billing by a provider for a more expensive service than the one performed
A sign that suggests that some type of illegal behavior may be occurring; triggers a closer review of a claim or situation
Physician performs a single service but bills it as a series of separate procedures
Government program that provides income benefits to people who cannot work because of a medical condition lasting 1 year or more
Law that provides the government with the authority to set and enforce safety and health standards for employers

Accepted Answer

The Answer of fraud indicator and Social Security Disability Insurance is...

Question 5

Medical benefits for an injured worker begin:
A)immediately and end 1 year after the date of the injury.
B)immediately and have no specific time limit.
C)after a 3-day waiting period and end 1 year after the date of the injury.
D)after a 3-day waiting period and have no specific time limit.

Accepted Answer

immediatel

Question 6

Examples of compensable injuries include all of the following EXCEPT:
A)falls in the company parking lot.
B)injuries incurred while working on a home improvement project using tools borrowed from work.
C)injuries that occur in a company restroom, break room, or cafeteria.
D)stress injuries caused by work conditions.

Accepted Answer

injuries incurred wh

Question 7

The injured worker or the insurance company must dispute an impairment rating or maximum medical improvement date within:
A)30 days from the date of notice.
B)45 days from the date of notice.
C)90 days from the date of notice.
D)120 days from the date of notice.

Accepted Answer

90 days fr

Question 8

Vocational rehabilitation involves the __________ of an injured employee to enable him or her to return to the workforce.

Accepted Answer

The answer of Vocational rehabilitation involves the __________ of an...

Question 9

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

Accepted Answer

the government plan

Question 10

Up to $6,000 of a deceased worker's funeral expenses can be paid as __________ benefits.

Accepted Answer

The answer of Up to $6,000 of a deceased worker's...

Question 11

Medical records for workers' compensation cases are to be kept separate from a patient's regular medical records.

Accepted Answer

A) True 
 B)False

Question 12

Workers' compensation fraud can be punishable by:
A)fines.
B)orders for restitution.
C)imprisonment.
D)all of the above.

Accepted Answer

The answer of Workers' compensation fraud can be punishable by:
A)fines.
B)orders...

Question 13

The four types of workers' compensation benefits are:
A)medical, disability, health, and death.
B)medical, income, disability, and death.
C)medical, income, death, and burial.
D)disability, suffering, death, and burial.

Accepted Answer

medical, i

Question 14

An impartial physician who helps to resolve a workers' compensation claim dispute is known as the:
A)treating doctor.
B)designated doctor.
C)physician of record.
D)primary care physician.

Accepted Answer

The answer of An impartial physician who helps to resolve...

Question 15

An injured worker is entitled to lifetime income benefits for all of the following conditions EXCEPT:
A)loss of one foot at or above the ankle.
B)total and permanent loss of sight in both eyes.
C)a physically traumatic injury to the brain resulting in incurable insanity.
D)third-degree burns covering the majority of either both hands or one hand and the face.

Accepted Answer

loss of on

Question 16

Social Security Disability Insurance (SSDI) is paid for by:
A)workers' payroll deductions matched by employer contributions.
B)income taxes paid by individuals.
C)taxes paid by corporations.
D)individuals who purchase SSDI policies.

Accepted Answer

workers' payroll ded

Question 17

How is reimbursement calculated for workers' compensation claims?

Accepted Answer

When the workers' compensation policy is

Question 18

The concept of workers' compensation insurance dates back to the late 1800s as a way to compensate workers who are injured on the job.

Accepted Answer

A) True 
 B)False

Question 19

What is meant by insurance fraud?

Accepted Answer

Insurance fraud is knowingly o

Question 20

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

Accepted Answer

The answer of An employee who is injured on the...

What is the primary responsibility of an injured worker with regard to his or her employer?

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

If a workers' compensation claim is denied, the provider can request a review by: A)the state workers' compensation insurance fund. B)the state insurance commissioner. C)a medical examination review committee. D)an independent review organization.

Medical benefits for an injured worker begin: A)immediately and end 1 year after the date of the injury. B)immediately and have no specific time limit. C)after a 3-day waiting period and end 1 year after the date of the injury. D)after a 3-day waiting period and have no specific time limit.

The injured worker or the insurance company must dispute an impairment rating or maximum medical improvement date within: A)30 days from the date of notice. B)45 days from the date of notice. C)90 days from the date of notice. D)120 days from the date of notice.

Vocational rehabilitation involves the __________ of an injured employee to enable him or her to return to the workforce.

Up to $6,000 of a deceased worker's funeral expenses can be paid as __________ benefits.

Medical records for workers' compensation cases are to be kept separate from a patient's regular medical records.

Workers' compensation fraud can be punishable by: A)fines. B)orders for restitution. C)imprisonment. D)all of the above.

The four types of workers' compensation benefits are: A)medical, disability, health, and death. B)medical, income, disability, and death. C)medical, income, death, and burial. D)disability, suffering, death, and burial.

An impartial physician who helps to resolve a workers' compensation claim dispute is known as the: A)treating doctor. B)designated doctor. C)physician of record. D)primary care physician.

Social Security Disability Insurance (SSDI) is paid for by: A)workers' payroll deductions matched by employer contributions. B)income taxes paid by individuals. C)taxes paid by corporations. D)individuals who purchase SSDI policies.

How is reimbursement calculated for workers' compensation claims?

The concept of workers' compensation insurance dates back to the late 1800s as a way to compensate workers who are injured on the job.

What is meant by insurance fraud?

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

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

Coding Procedures and Services

Hcpcs and Coding 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

Electronic Medical Claims Processing

Filters

Exam 18: Workers Compensation

What is the primary responsibility of an injured worker with regard to his or her employer?

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

If a workers' compensation claim is denied, the provider can request a review by: A)the state workers' compensation insurance fund. B)the state insurance commissioner. C)a medical examination review committee. D)an independent review organization.

Medical benefits for an injured worker begin: A)immediately and end 1 year after the date of the injury. B)immediately and have no specific time limit. C)after a 3-day waiting period and end 1 year after the date of the injury. D)after a 3-day waiting period and have no specific time limit.

The injured worker or the insurance company must dispute an impairment rating or maximum medical improvement date within: A)30 days from the date of notice. B)45 days from the date of notice. C)90 days from the date of notice. D)120 days from the date of notice.

Vocational rehabilitation involves the __________ of an injured employee to enable him or her to return to the workforce.

Up to $6,000 of a deceased worker's funeral expenses can be paid as __________ benefits.

Medical records for workers' compensation cases are to be kept separate from a patient's regular medical records.

Workers' compensation fraud can be punishable by: A)fines. B)orders for restitution. C)imprisonment. D)all of the above.

The four types of workers' compensation benefits are: A)medical, disability, health, and death. B)medical, income, disability, and death. C)medical, income, death, and burial. D)disability, suffering, death, and burial.

An impartial physician who helps to resolve a workers' compensation claim dispute is known as the: A)treating doctor. B)designated doctor. C)physician of record. D)primary care physician.

Social Security Disability Insurance (SSDI) is paid for by: A)workers' payroll deductions matched by employer contributions. B)income taxes paid by individuals. C)taxes paid by corporations. D)individuals who purchase SSDI policies.

How is reimbursement calculated for workers' compensation claims?

The concept of workers' compensation insurance dates back to the late 1800s as a way to compensate workers who are injured on the job.

What is meant by insurance fraud?

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

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

Coding Procedures and Services

Hcpcs and Coding 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

Electronic Medical Claims Processing

Filters