Insurance Health Basics/Health Insurance Claim Form-hi-1011 Chapters 17 & 18

21 Questions | Total Attempts: 290

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Health Insurance Quizzes & Trivia

Practice for the Medcial Admin Assistant certification exam


Questions and Answers
  • 1. 
    The birthday rule is when an individual is covered by two insurance policies, the insurance plan of the policyholder whose birthday comes first in the calendar year becomes the primary insurance.
    • A. 

      True

    • B. 

      False

  • 2. 
    Managed care has high out of pocket costs
    • A. 

      True

    • B. 

      False

  • 3. 
    Group coverages are more expensive because they cover a larger group of individuals.
    • A. 

      True

    • B. 

      False

  • 4. 
    Having an authorization from the insuarance company guarantees that the provider will be paid
    • A. 

      True

    • B. 

      False

  • 5. 
    There is no difference if a patient is in or out of network
    • A. 

      True

    • B. 

      False

  • 6. 
    UCR formula is used by insurance companies to determine the fee schedule
    • A. 

      True

    • B. 

      False

  • 7. 
    Medicaid is federal and state health insurance
    • A. 

      True

    • B. 

      False

  • 8. 
    The patient is responsible for the premium, co-pay and deductible
    • A. 

      True

    • B. 

      False

  • 9. 
    If the patient is covered under more than one insurance, they can chosse which insurance can be billed first
    • A. 

      True

    • B. 

      False

  • 10. 
    More than one fee scheduled can be utilized in the office for billing
    • A. 

      True

    • B. 

      False

  • 11. 
    Disability policies can be issued as short term, mid term and long term
    • A. 

      True

    • B. 

      False

  • 12. 
    Electronic claim processing uses an 837P format for billing.
    • A. 

      True

    • B. 

      False

  • 13. 
    The claim only has information regarding the patient
    • A. 

      True

    • B. 

      False

  • 14. 
    Insurance companies utilize all the boxes on the claim form.
    • A. 

      True

    • B. 

      False

  • 15. 
    A denied claim can be a result of which of the following
    • A. 

      Has illogical information

    • B. 

      Problem with the fiscal intermediary

    • C. 

      Missing information

    • D. 

      Applied to the deductible

  • 16. 
    POS codes identify
    • A. 

      The services performed

    • B. 

      The facility where service were performed

    • C. 

      The insurance used for the services performed

    • D. 

      The doctor who performed the services.

  • 17. 
    A claim that has be returned from the insurance company with a code represents the claim is
    • A. 

      Clean

    • B. 

      Rejected

    • C. 

      Paid

    • D. 

      Statused

  • 18. 
    Which one of the following is not a rule of completing the CMS1500 form
    • A. 

      Use a six digit format for the date

    • B. 

      Omit all punctuation

    • C. 

      Do not write on the form

    • D. 

      Do not staple anything to the form

  • 19. 
    A suspended claim with an insurance company that could eventually be denied or paid is considered what type of claim
    • A. 

      Pending

    • B. 

      Incomplete

    • C. 

      Invalid

    • D. 

      Denied

  • 20. 
    CMS1500 used to be referred to as HCFA1500
    • A. 

      True

    • B. 

      False

  • 21. 
    CMS1500 is considered a universal claim form
    • A. 

      True

    • B. 

      False

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