Health Insurance Chap 8 & 11

54 Questions  I  By Coofoogirl555
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Health Insurance Quizzes & Trivia
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  • 1. 
    A combination federal/state medical assistance program that provides comprehensive and quality medical care for certain categories of low income and qualifying elderly people is
    • A. 

      Medicare

    • B. 

      Medicaid

    • C. 

      Champva

    • D. 

      Blue cross and blue shield


  • 2. 
    The acronym for the medicaid program that was formerly referred to as AFDC is
    • A. 

      TANF

    • B. 

      Hippa

    • C. 

      Cobra

    • D. 

      Tricare


  • 3. 
    To qualify for supplemental security income (SSI) individuals must meet certain financial guidelines set by
    • A. 

      The U.S. constitution

    • B. 

      Individual state laws

    • C. 

      The federal poverty level (FPL)

    • D. 

      The centers for medicare and medicaid services (CMS)


  • 4. 
    The amount of the SSI payment is the difference between the federal benefit rate (FBR) and the persons
    • A. 

      Net worth

    • B. 

      Average wage

    • C. 

      Taxable income

    • D. 

      Countable income


  • 5. 
    The medicaid program is administered by the
    • A. 

      AMA

    • B. 

      CMS

    • C. 

      HIPPA

    • D. 

      NAFTA


  • 6. 
    In order to receive federal matching funds in its medicaid program title XIX of the social security act requires that states offer certain basic services called
    • A. 

      Monitoring

    • B. 

      Service matching

    • C. 

      Mandated services

    • D. 

      Medicaid equalization


  • 7. 
    Medically need individuals can reduce their assets to the medicaid eligibility level by deducting medical expenses this is called a/an
    • A. 

      Use tariff

    • B. 

      Spend down

    • C. 

      Expense equalization

    • D. 

      Medical expense payout


  • 8. 
    A commercial insurer contracted by the department of health and human services (HHS) for the purpose of processing and administering medicaid claims is a
    • A. 

      Claims contractor

    • B. 

      Fiscal intermediary

    • C. 

      Commercial advisor

    • D. 

      Medicaid administrator


  • 9. 
    Individuals who receive medical assistance because their income falls within the poverty or FPL guidelines or as a result of SSI eligibility are considered
    • A. 

      Medically needy

    • B. 

      Medically deprived

    • C. 

      Categorically needy

    • D. 

      Medically challenged


  • 10. 
    The acronym for the program that provides comprehensive alternative care for non institutionalized elderly who otherwise would be in a nursing home is
    • A. 

      PACE

    • B. 

      COBRA

    • C. 

      SCHIP

    • D. 

      EMTLA


  • 11. 
    As a general rule medicaid pays only for services that are
    • A. 

      Over $100

    • B. 

      Experimental

    • C. 

      Federally mandated

    • D. 

      Medically necessary


  • 12. 
    Before providing services to patients claiming to be on medicaid the health insurance professional should
    • A. 

      Complete a claim

    • B. 

      Verify eligibility

    • C. 

      Check references

    • D. 

      Ask for payment upfront


  • 13. 
    An individual who is eligible for both medicare and medicaid programs is said to be a/an
    • A. 

      Dual eligible

    • B. 

      Dual qualifier

    • C. 

      Elderly qualifier

    • D. 

      Tax exempt aged


  • 14. 
    When an individual is covered under both medicaid and medicare and/or a private healthcare policy the payer of last resort is always
    • A. 

      Medicare

    • B. 

      Medicaid

    • C. 

      Medigap

    • D. 

      The private insurer


  • 15. 
    When one state allows medicaid beneficiaries to be treated in an adjacent state it is referred to as
    • A. 

      Illegal

    • B. 

      Joint care

    • C. 

      Reciprocity

    • D. 

      Dual state eligibility


  • 16. 
    When a medicaid beneficiary has no other healthcare coverage the type of claim to be submitted is called a
    • A. 

      State claim

    • B. 

      Unilateral claim

    • C. 

      Functional claim

    • D. 

      Medicaid simple claim


  • 17. 
    Congress established the medicaid program under title XIX of the social security act in 1965
    • A. 

      True

    • B. 

      False


  • 18. 
    Every state has the medicaid benefits
    • A. 

      True

    • B. 

      False


  • 19. 
    There is a medicaid program in all 50 states the district of columbia and u.s. territories
    • A. 

      Ture

    • B. 

      False


  • 20. 
    CMS determines eligibility criteria for SSI
    • A. 

      True

    • B. 

      False


  • 21. 
    The federal government establishes broad national guidelines for medicaid eligibility and each state establishes its own eligibility standards within federal guidelines
    • A. 

      True

    • B. 

      False


  • 22. 
    States must cover categorically needy individuals but are free to define this category
    • A. 

      True

    • B. 

      False


  • 23. 
    States must participate in the state childrens health insurance program (SCHIP)
    • A. 

      True

    • B. 

      False


  • 24. 
    Individuals meeting family medical criteria fall into the medically needy category
    • A. 

      True

    • B. 

      False


  • 25. 
    Hospitals that receive additional payments to ensure that communities have access to certain high cost services are called disproportional share hospitals
    • A. 

      True

    • B. 

      False


  • 26. 
    All healthcare providers in all states must accept medicaid patients
    • A. 

      True

    • B. 

      False


  • 27. 
    Medicaid recipients who qualify for benefits in January will qualify for the remainder of the year
    • A. 

      True

    • B. 

      False


  • 28. 
    One method of verifying medicaid eligibility is the automated voice response system
    • A. 

      True

    • B. 

      False


  • 29. 
    In order to qualify for medicaid the individual must be at least 65 years of age
    • A. 

      True

    • B. 

      False


  • 30. 
    Most states have their own specific for to use for medicaid claims
    • A. 

      True

    • B. 

      False


  • 31. 
    Every time a medicaid claim is submitted a document is generated called a remittance advice (RA)
    • A. 

      True

    • B. 

      False


  • 32. 
    Medicaid payments are normally sent directly to the provider and balance billing is not allowed
    • A. 

      True

    • B. 

      False


  • 33. 
    The legal obligation of other insurance policies/programs to pay all or part of the expenditures for medical assistance furnished under a state plan is referred to as ___________ __________ _______________.

  • 34. 
    Because of certain side effects of atomoxetine (strattera) children taking this medication should be monitored for
    • A. 

      Enuresis

    • B. 

      Growth and development

    • C. 

      Dizziness

    • D. 

      Diarrhea


  • 35. 
    Hypnotic and sedative agents can become lethal when taken in combination with which of the following?
    • A. 

      Central nervous system (CNS) stimulant agents

    • B. 

      CNS depressant agents

    • C. 

      Antibiotic agents

    • D. 

      Antacid agents


  • 36. 
    Because of a common side effect of narcotic analgesic agents such as morphine patients who are taking them on a regular basis should most likely be taking which of the following in addition
    • A. 

      Stool softeners

    • B. 

      Antacid agents

    • C. 

      Anticoagulant agents

    • D. 

      Bronchodilator agents


  • 37. 
    Atropine is given preoperatively with narcotic medications for which of the following reasons
    • A. 

      Potentiation of analgesia and decreased peristalsis

    • B. 

      Reduction of secretions in the mouth and respiratory tract and decreased respiratory depression

    • C. 

      Prevention of cardiac arrhythmia's and regulation of heart rate

    • D. 

      Increased secretion of tears and temperature regulation


  • 38. 
    One advantage of fentanyl (duragesic) for analgesia is which of the following
    • A. 

      It is not habit forming

    • B. 

      It is available in transdermal patches

    • C. 

      It does not pass into breast milk

    • D. 

      It does not cause drug interactions with other medications


  • 39. 
    Reversal of overdoses of narcotic and opioid agents is managed with which of the following
    • A. 

      Narcan

    • B. 

      Romazicon

    • C. 

      Pavulon

    • D. 

      Eserine


  • 40. 
    Risk of reyes syndrome can be avoided in children with fever by using which of the following antipyretic agents
    • A. 

      Darvon

    • B. 

      Stadol

    • C. 

      Tylenol

    • D. 

      Imitrex


  • 41. 
    The side effects of sumatriptan (imitrex) may produce which of the following
    • A. 

      Angina or hypertension

    • B. 

      Orthostatic hypotension

    • C. 

      Blurred vision

    • D. 

      Fever of malaise


  • 42. 
    To improve appetite and digestion in a nursing home client which of the following might be prescribed
    • A. 

      Corticosteroid agents

    • B. 

      Antihistamine agents

    • C. 

      Alcohol

    • D. 

      Analgesic agents


  • 43. 
    Which of the following is used to control the pain of trigeminal neuralgia in addition to seizures
    • A. 

      Dilantin

    • B. 

      Cerebyx

    • C. 

      Tegretol

    • D. 

      Klonopin


  • 44. 
    Which of the following is a combination product used in the treatment of parkinsons disease
    • A. 

      Larodopa

    • B. 

      Dopar

    • C. 

      Methyldopa

    • D. 

      Sinemet


  • 45. 
    Which of the following drugs stimulate the central nervous system (CNS)
    • A. 

      Alcohol

    • B. 

      Analgesic agents

    • C. 

      Anesthetic agents

    • D. 

      Amphetamine agents


  • 46. 
    Which of the following can be used in transdermal patches to treat pain
    • A. 

      Codeine

    • B. 

      Demerol

    • C. 

      Duragesic

    • D. 

      Catapres


  • 47. 
    Naloxone (narcan) is given for the treatment of which of the following
    • A. 

      Neuropathic pain

    • B. 

      Narcotic overdose

    • C. 

      Nonspecific inflammation

    • D. 

      New onset parkinsons disease


  • 48. 
    Which synthetic opioid agent is preferred over morphine in obstetrics
    • A. 

      Duragesic

    • B. 

      Demerol

    • C. 

      Dolophine

    • D. 

      Codeine


  • 49. 
    Which medication is effective in the control of tonic-clonic seizures
    • A. 

      Klonopin

    • B. 

      Tegretol

    • C. 

      Valium

    • D. 

      Zarontin


  • 50. 
    Long term use of opioid analgesic agents often leads to which of the following conditions
    • A. 

      Constipation

    • B. 

      Diarrhea

    • C. 

      Ulcers

    • D. 

      Gastrointestinal bleeding


  • 51. 
    Which of the following characterizes absence seizures
    • A. 

      Tonic-clonic movements

    • B. 

      Loss of bladder and or bowel control

    • C. 

      Repetitive nonproductive motions

    • D. 

      Alteration of consciousness lasting only a few seconds


  • 52. 
    The mechanism of action of local anesthetic agents is which of the following
    • A. 

      Depressing the cerebral cortex where painful stimuli are perceived

    • B. 

      Blocking the nerve conduction of pain to the brain

    • C. 

      Enhancing the transmission of antipain stimulus from the brain

    • D. 

      Creating an amnestic effect so that the patient forgets about pain


  • 53. 
    Which drug is prescribed for the treatment of restless leg syndrome
    • A. 

      Rozerem

    • B. 

      Mirapex

    • C. 

      Stadol

    • D. 

      Imitrex


  • 54. 
    Methylphenidate (daytrana) differs from methylphenidate (ritalin) in what way
    • A. 

      Daytrana is for patients younger that 10 yrs old ritalin is for patients 11 yrs and older

    • B. 

      Daytrana is available by prescription only ritalin is available over the counter

    • C. 

      Daytrana is a transdermal patch ritalin is an oral medication

    • D. 

      Daytrana is a canadian product ritalin is sold in the united states


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