Introduction To Health Insurance Quiz
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Navigate the intricate world of healthcare financing with our "Introduction to Health Insurance Quiz." Tailored for individuals seeking to demystify the complexities of health insurance, this quiz is a comprehensive exploration of key concepts in the realm of healthcare coverage.
Whether you're a healthcare professional, a student, or an individual looking to understand the nuances of health insurance, this quiz offers an engaging opportunity to test your knowledge. From policy terms to understanding coverage options, each question is thoughtfully crafted to enhance your understanding of this critical aspect of healthcare.
Ready to decode the language of health insurance and gain Read moreinsights into the vital components of coverage? Take the quiz now and empower yourself with foundational knowledge in the realm of health insurance!
- 1.
Which was the first commercial insurance company in the United States to provide private healthcare coverage for injuries not resulting in death?
- A.
Baylor University Health Plan
- B.
Blue Cross and Blue Shield Association
- C.
Franklin Health Assurance Company
- D.
Office of Workers Compensation Program
Correct Answer
C. Franklin Health Assurance CompanyExplanation
The correct answer is Franklin Health Assurance Company. This company was the first commercial insurance company in the United States to offer private healthcare coverage for injuries that did not result in death.Rate this question:
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- 2.
Which replaced the 1908 workers compensation legislation and provided civilian employees of the federal government with medical care,survivors benefits and compensation for lost wages?
- A.
Black Lung Benefit Reform Act
- B.
Federal Employees Compensation Act
- C.
Long shore and Harbor Workers Act
- D.
Office of Workers Compensation Programs
Correct Answer
B. Federal Employees Compensation ActExplanation
The Federal Employees Compensation Act replaced the 1908 workers compensation legislation and provided civilian employees of the federal government with medical care, survivors benefits, and compensation for lost wages.Rate this question:
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- 3.
Which replaced the 1908 Workers Compensation legislation and provided civilian employees of the federal government with medical care, survivors benefits and compensation for lost wages?
- A.
Black Lung Benefits Reform Act
- B.
Federal Employees Compensation Act
- C.
Long Shore and Harbor Workers Compensation Act
- D.
Office of Workers Compensation Act
Correct Answer
B. Federal Employees Compensation ActExplanation
The correct answer is the Federal Employees Compensation Act. This act replaced the 1908 Workers Compensation legislation and provided medical care, survivors benefits, and compensation for lost wages to civilian employees of the federal government.Rate this question:
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- 4.
The first Blue Cross policy was introduced by?
- A.
Baylor University in Dallas Texas
- B.
Harvard University in Cambridge, Massachusetts
- C.
Kaiser Permanente in Los Angelas
- D.
American Medical Association Representatives
Correct Answer
A. Baylor University in Dallas TexasExplanation
The correct answer is Baylor University in Dallas, Texas. The Blue Cross policy was first introduced by Baylor University in Dallas, Texas.Rate this question:
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- 5.
The Blue Shield concept grew out of the lumber and mining camps of the______ region at the turn of the century
- A.
Great Plains
- B.
New England
- C.
Pacific Northwest
- D.
Southwest
Correct Answer
C. Pacific NorthwestExplanation
The Blue Shield concept grew out of the lumber and mining camps of the Pacific Northwest region at the turn of the century. This region was known for its abundant natural resources and booming industries, which led to the establishment of camps and communities to support the workers. The Blue Shield concept, which aimed to provide healthcare services to these workers, likely emerged in response to the need for medical care and support in these remote and often hazardous environments.Rate this question:
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- 6.
Healthcare coverage offered by ________ is called group health care
- A.
A state
- B.
CMS
- C.
Employees
- D.
Employers
Correct Answer
D. EmployersExplanation
Group health care coverage is typically offered by employers to their employees. This type of coverage allows a group of individuals, such as employees of a particular company, to access healthcare services and benefits collectively. Employers often negotiate and provide group health insurance plans to their employees as part of their employee benefits package. This coverage is different from individual health insurance plans that individuals purchase on their own.Rate this question:
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- 7.
The Hill-Burton Act provided federal grants for modernizing hospitals that had become obsolete because of lack of capital investment during the great depression and world war II (1929-1945). In return for federal funds,
- A.
Facilities were required to provide services free or at a reduced rates to patients unable to pay for care.
- B.
Medical group practices were formed to allow providers to share equipment,supplies and personnel.
- C.
National coordinating agencies for physician sponsored health insurance plans were created.
- D.
Universal health insurance was provided to those who could not afford health insurance.
Correct Answer
A. Facilities were required to provide services free or at a reduced rates to patients unable to pay for care.Explanation
The Hill-Burton Act aimed to modernize hospitals that had become outdated due to lack of investment during the Great Depression and World War II. To receive federal grants, these facilities were obligated to offer services either for free or at reduced rates to patients who were unable to afford healthcare. This provision ensured that healthcare services would be accessible to those in need, even if they couldn't afford to pay for it.Rate this question:
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- 8.
Third party administrators (TPA's) administered health care plans and process claims serving as a
- A.
Clearing house for data submitted by government agencies
- B.
Medidcare administrative contractor (MAC)for business owners
- C.
System of checks and balances for labor and managment
- D.
Third party payers for employers
Correct Answer
C. System of checks and balances for labor and managmentExplanation
The correct answer is "system of checks and balances for labor and management." This answer suggests that third party administrators (TPA's) play a role in ensuring fairness and accountability between labor and management in the administration of health care plans and processing of claims. They act as a neutral party that monitors and oversees the activities of both parties, ensuring that neither takes advantage of the other. This helps to maintain a balanced and fair system for all stakeholders involved.Rate this question:
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- 9.
Major medical insurance provides coverage for______ illness and injuries, incorporating large deductibles and lifetime maximum amounts
- A.
Acute care
- B.
Catastrophic or prolonged
- C.
Presently diagnosed
- D.
Work related
Correct Answer
B. Catastrophic or prolongedExplanation
Major medical insurance provides coverage for catastrophic or prolonged illness and injuries, incorporating large deductibles and lifetime maximum amounts. This type of insurance is designed to protect individuals from high medical expenses that may arise from serious or long-term health conditions. By offering coverage for catastrophic or prolonged illnesses, major medical insurance ensures that individuals have financial protection in case of unexpected and costly medical events. The inclusion of large deductibles and lifetime maximum amounts helps to manage the overall cost of the insurance plan while still providing coverage for significant medical expenses.Rate this question:
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- 10.
The Government health plan that provides healthcare services to Americans over the age of 65 is called
- A.
Medicare
- B.
Medicaid
- C.
CHAMPUS
- D.
TRICARE
Correct Answer
A. MedicareExplanation
Medicare is the correct answer because it is a government health plan specifically designed to provide healthcare services to Americans who are 65 years old or older. It is a federal program that helps cover medical expenses such as hospital stays, doctor visits, prescription drugs, and preventive services for eligible individuals. Medicaid, CHAMPUS, and TRICARE are also government health plans, but they serve different populations and have different eligibility criteria.Rate this question:
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- 11.
The percentage of cost a patient shares with the health plan( e.g., plan pays 80% of cost and the patient pays 20%) is called
- A.
Coinsurance
- B.
Copay
- C.
Deductable
- D.
Maximum
Correct Answer
A. CoinsuranceExplanation
Coinsurance refers to the percentage of the cost of healthcare services that a patient is responsible for paying, while the health plan covers the remaining percentage. In this case, the health plan pays 80% of the cost and the patient pays 20%. Coinsurance is different from copay, which is a fixed amount that a patient pays for specific services, and deductible, which is the amount a patient must pay out of pocket before the health plan starts covering costs. Maximum is not the correct answer as it does not relate to the cost-sharing between the patient and the health plan.Rate this question:
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- 12.
The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) enacted the _____ perspective payer systems (pps)
- A.
Ambulatory payment classification
- B.
Diagnosis related groups
- C.
Fee for service reembursment
- D.
Resource based relative value scale system
Correct Answer
B. Diagnosis related groupsExplanation
The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) enacted the diagnosis related groups (DRGs) payer system. DRGs are a classification system used by Medicare to categorize patients and determine reimbursement rates based on their diagnoses, procedures, age, and other factors. This system aims to standardize payments for hospital services and promote efficiency in healthcare delivery.Rate this question:
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- 13.
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all laboratory testing to ensure the accuracy,reliability and timelines of patient test results
- A.
Only at hospitals and other large institutions
- B.
Regardless of where the teat was performed
Correct Answer
B. Regardless of where the teat was performedExplanation
The correct answer is "regardless of where the test was performed". The explanation is that the Clinical Laboratory Improvement Act (CLIA) applies to all laboratory testing, not just those conducted at hospitals and large institutions. This means that regardless of where the test is performed, whether it is at a hospital, clinic, or any other healthcare facility, the CLIA standards for quality, accuracy, reliability, and timeliness of patient test results must be followed.Rate this question:
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- 14.
The primary intent of HIPPA legislation is to...
- A.
Combine healthcare financing and quality assurance programs into a single agency
- B.
Create better access to health insurance, limit fraud and abuse, and reduce administrative cost
- C.
Provide health insurance to uninsured low income children by expanding the Medicaid program
- D.
Protect all employees against injuries from occupational hazards in the work place
Correct Answer
B. Create better access to health insurance, limit fraud and abuse, and reduce administrative costExplanation
The correct answer is "create better access to health insurance, limit fraud and abuse, and reduce administrative cost." The primary intent of HIPPA legislation is to improve the healthcare system by ensuring that individuals have better access to health insurance coverage, protecting their privacy and security of their health information, reducing fraud and abuse in the healthcare industry, and streamlining administrative processes to make healthcare more efficient and cost-effective.Rate this question:
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- 15.
Utilization and quality control review of health care furnished, or to be furnished, or to be furnished,to Medicare beneficiaries is currently performed by...
- A.
Consumer driven health plans
- B.
Peer review organizations
- C.
Professional standards review organizations
- D.
Quality improvement organizations
Correct Answer
D. Quality improvement organizationsExplanation
Quality improvement organizations are currently responsible for the utilization and quality control review of health care provided to Medicare beneficiaries. These organizations work to ensure that the care being delivered meets established standards and guidelines. They review the services provided and identify areas for improvement, with the goal of enhancing the overall quality and efficiency of healthcare for Medicare beneficiaries. Peer review organizations, professional standards review organizations, and consumer-driven health plans are not specifically responsible for this task.Rate this question:
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- 16.
The National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and eliminates improper coding. NCCI edits are developed based on coding conventions defined i ______. current standards of medical and surgical coding practice, input from specialty societies, and analysis of current coding practices.
- A.
CPT
- B.
ICD
- C.
HCPCS level II
- D.
NDC
Correct Answer
A. CPTExplanation
The National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and eliminates improper coding. NCCI edits are developed based on coding conventions defined in current standards of medical and surgical coding practice, input from specialty societies, and analysis of current coding practices. CPT (Current Procedural Terminology) is a coding system used for reporting medical procedures and services. Therefore, CPT is the correct answer as it aligns with the explanation provided.Rate this question:
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- 17.
Which is a primary purpose of the patient record?
- A.
Ensure the continuity of care
- B.
Evaluate quality of care
- C.
Provide data for use in research
- D.
Submit data to third party payers
Correct Answer
A. Ensure the continuity of careExplanation
The primary purpose of the patient record is to ensure the continuity of care. This means that the record serves as a comprehensive and accurate documentation of the patient's medical history, treatment plans, medications, and other relevant information. It allows healthcare providers to have a complete understanding of the patient's health status, enabling them to make informed decisions and provide appropriate and consistent care over time. The patient record also facilitates communication and coordination among different healthcare professionals involved in the patient's care, ensuring that there is a seamless transition between different healthcare settings or providers.Rate this question:
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- 18.
The problem-oriented record (POR) include the following four components
- A.
Chief complaint, review of systems,physical examination, laboratory data
- B.
Database,problem list,initial plan, progress notes
- C.
Diagnostic plans, management plans, therapeutic plans, patient education plans
- D.
Subjective, objective, assessment,plan
Correct Answer
D. Subjective, objective, assessment,planExplanation
The correct answer is subjective, objective, assessment, plan. This is because the components listed in the answer (subjective, objective, assessment, plan) are commonly used in the problem-oriented record (POR). The subjective component includes the patient's complaints and symptoms, while the objective component includes the results of physical examinations and laboratory data. The assessment component involves the healthcare provider's evaluation and diagnosis, and the plan component outlines the intended treatment and management plans for the patient.Rate this question:
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- 19.
The electronic health record (EHR) allows patient information to be created at different locations according to a unique patient identifier or identification number,which is called
- A.
Evidence based decision support
- B.
Health data managment
- C.
Record linkage
- D.
Surveillance and reporting
Correct Answer
C. Record linkageExplanation
The correct answer is record linkage. Record linkage refers to the process of connecting or linking different health records of the same patient, which were created at different locations, using a unique patient identifier or identification number. This allows for a comprehensive and consolidated view of the patient's health information, regardless of where it was generated. By linking these records, healthcare providers can have a more complete understanding of the patient's medical history, leading to better decision-making and improved patient care.Rate this question:
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- 20.
When a patient states " I haven't been able to sleep for weeks" the provider who uses the soap format documents that statement in the ________ portion of the clinic notes
- A.
Assesment
- B.
Objective
- C.
Plan
- D.
Subjective
Correct Answer
D. SubjectiveExplanation
In the SOAP format, the subjective portion of the clinic notes is where the provider documents the patient's statements, feelings, and symptoms. This includes any information that the patient shares about their condition, such as their inability to sleep for weeks. The subjective portion is important for understanding the patient's perspective and gathering information about their symptoms and concerns.Rate this question:
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- 21.
The provider who uses the SOAP format documents the physical examination in the ________ portion of the clinic note.
- A.
Assessment
- B.
Objective
- C.
Plan
- D.
Subjective
Correct Answer
B. ObjectiveExplanation
In SOAP format, the objective portion of the clinic note is where the provider documents the physical examination. This section includes factual and measurable information about the patient's physical findings, such as vital signs, physical appearance, and any abnormalities or observations made during the examination. It is important for providers to accurately and objectively document this information to ensure effective communication with other healthcare professionals and to provide a comprehensive view of the patient's condition.Rate this question:
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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
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Current Version
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Dec 07, 2023Quiz Edited by
ProProfs Editorial Team -
Oct 12, 2012Quiz Created by
Phliproc
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