NCCT - Medical Office Management

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| By Mikeba Hill
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Mikeba Hill
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  • 1/50 Questions

    A BED PATIENT IN A HOSPITAL IS CALLED A(N)?

    • INPATIENT
    • OUTPATIENT
    • THIRD PARTY PAYER
    • PROVIDER
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About This Quiz

NCCT - MEDICAL OFFICE MANAGEMENT - PART C - FINANCIAL MANAGEMENT

NCCT - Medical Office Management - Quiz

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  • 2. 

    AN UNEXPECTED EVENT WHICH MAY CAUSE INJURY IS CALLED?

    • DREAD DISEASE RIDER

    • ACCIDENT

    • ADJUSTER

    • NO CORRECT ANSWER

    Correct Answer
    A. ACCIDENT
    Explanation
    An unexpected event that may cause injury is called an accident. Accidents can happen suddenly and without warning, resulting in harm or injury to individuals involved. This term is commonly used to describe incidents such as car crashes, falls, or workplace mishaps that can lead to physical harm or damage.

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  • 3. 

    A PATIENT RECEIVING AMBULATORY CARE AT A HOSPITAL OR OTHER HEALTH FACILITY WITHOUT BEING ADMITTED AS A BED PATIENT IS CALLED A(N)?

    • INPATIENT

    • OUTPATIENT

    • CARRIER

    • ADJUSTER

    Correct Answer
    A. OUTPATIENT
    Explanation
    An outpatient is a patient who receives medical care at a hospital or health facility without being admitted as a bed patient. This means that they do not stay overnight and are not required to be admitted to the hospital. Outpatients typically receive treatment, tests, or consultations and then go home the same day.

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  • 4. 

    A HEALTH PROGRAM FOR PEOPLE AGE 65 AND OLDER UNDER SOCIAL SECURITY IS CALLED?

    • TRI-CARE

    • MEDICARE

    • CHAMPVA

    • WORKERS' COMPENSATION

    Correct Answer
    A. MEDICARE
    Explanation
    Medicare is a health program for people aged 65 and older under Social Security. It provides medical coverage and benefits to help with healthcare costs. Tri-Care is a health program for military personnel, CHAMPVA is a health program for veterans, and Workers' Compensation is a program that provides benefits for employees who are injured or become ill due to their job. Therefore, Medicare is the correct answer for the given question.

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  • 5. 

    TO CORRECT A HANDWRITTEN ERROR IN A PATIENT'S CHART, IT IS ONLY ACCEPTABLE TO?

    • WHITE IT OUT NEATLY & INSERT THE CORRECT INFORMATION

    • WRITE OVER THE ERROR

    • SCRATCH THROUGH THE ERROR SO IT CANNOT BE READ

    • DRAW A LINE THROUGH THE ERROR, INSERT THE CORRECT INFORMATION, DATE & INITIAL IT

    Correct Answer
    A. DRAW A LINE THROUGH THE ERROR, INSERT THE CORRECT INFORMATION, DATE & INITIAL IT
  • 6. 

    A FORM OF INSURANCE PAID BY THE EMPLOYER PROVIDING CASH BENEFITS TO WORKERS INJURED OR DISABLED IN THE COURSE OF EMPLOYMENT IS CALLED?

    • TRI-CARE

    • CHAMPUS

    • WORKERS' COMPENSATION

    • MEDICAID

    Correct Answer
    A. WORKERS' COMPENSATION
    Explanation
    Workers' Compensation is a form of insurance paid by the employer that provides cash benefits to workers who are injured or disabled while on the job. It is a system that helps protect employees by ensuring that they receive financial compensation for medical expenses, lost wages, and rehabilitation services related to their work-related injuries or disabilities. This insurance coverage is mandatory for most employers and helps to ensure that workers are taken care of in the event of a workplace accident or injury.

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  • 7. 

    AN AMOUNT THE INSURED MUST PAY BEFORE POLICY BENEFITS BEGIN IS CALLED?

    • INDEMNITY

    • EXTENDED BENEFITS

    • DEDUCTIBLE

    • CATASTROPHIC

    Correct Answer
    A. DEDUCTIBLE
    Explanation
    A deductible is an amount that the insured must pay out of pocket before the insurance policy benefits begin. It is a form of cost-sharing between the insurance company and the insured. The purpose of a deductible is to discourage small and frequent claims, as the insured is responsible for covering a portion of the expenses. Once the deductible is paid, the insurance company will then cover the remaining costs up to the policy limits. Deductibles can vary depending on the type of insurance policy and coverage.

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  • 8. 

    A PREVIOUS INJURY, DISEASE OR pHYSICAL CONDITION THAT EXISTED BEFORE THE HEALTH INSURANCE POLICY WAS ISSUED IS CALLED?

    • PREEXISTING CONDITION

    • PRIOR EXPOSURE

    • FOREGOING CONDITION

    • NO CORRECT ANSWER

    Correct Answer
    A. PREEXISTING CONDITION
    Explanation
    A preexisting condition refers to an injury, disease, or physical condition that already existed before the health insurance policy was issued. This means that the individual had the condition prior to obtaining the insurance coverage.

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  • 9. 

    A PERSON OR INSTITUTION THAT GIVES MEDICAL CARE IS A(N)?

    • THIRD-PARTY PAYER

    • PROVIDER

    • ADJUSTER

    • INSURANCE AGENT

    Correct Answer
    A. PROVIDER
    Explanation
    A person or institution that gives medical care is referred to as a provider. This term encompasses healthcare professionals such as doctors, nurses, hospitals, clinics, and other healthcare facilities that offer medical services to patients. Providers play a crucial role in delivering healthcare and are responsible for diagnosing, treating, and managing patients' medical conditions. They may be reimbursed directly by patients or through third-party payers such as insurance companies.

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  • 10. 

    A FORM TO ITEMIZE DEPOSITS MADE TO SAVINGS OR CHECKING ACCOUNTS IS CALLED?

    • DEPOSIT SLIP

    • MONEY ORDER

    • CHECK GUARANTEE

    • NO CORRECT ANSWER

    Correct Answer
    A. DEPOSIT SLIP
    Explanation
    A form to itemize deposits made to savings or checking accounts is called a deposit slip. This slip is used by individuals to record the details of the deposit, such as the account number, the amount being deposited, and the date. It serves as a proof of the transaction and helps the bank in accurately crediting the funds to the account.

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  • 11. 

    A RECAP SHEET THAT ACCOMPANIES A MEDICARE OR MEDICAID CHECK, SHOWING BREAKDOWN & EXPLANATION OF PAYMENT ON A CLAIM IS CALLED?

    • FEE-FOR-SERVICE

    • EXPLANATION OF BENEFITS

    • COORDINATION OF BENEFITS

    • DUAL CHOICE

    Correct Answer
    A. EXPLANATION OF BENEFITS
    Explanation
    An explanation of benefits is a recap sheet that accompanies a Medicare or Medicaid check, showing a breakdown and explanation of payment on a claim. It provides detailed information about the services provided, the amount billed, the amount paid by the insurance company, and any remaining balance that may be the responsibility of the patient. This document helps the patient understand how their insurance coverage is being applied to their healthcare expenses.

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  • 12. 

    A METHOD OF CHARGING WHEREBY A pHYSICIAN PRESENTS A BILL FOR EACH SERVICE RENDERED IS CALLED?

    • NON DUPLICATION OF BENEFITS

    • FEE-FOR-SERVICE

    • MONTHLY STATEMENT

    • NO CORRECT ANSWER

    Correct Answer
    A. FEE-FOR-SERVICE
    Explanation
    Fee-for-service is a method of charging where a physician presents a bill for each service rendered. This means that the patient is charged separately for each individual service or procedure that they receive from the physician. This method allows for transparency in pricing and allows the physician to be compensated for each specific service they provide. It is a common payment model in healthcare where the patient pays for each service they receive, rather than a bundled or prepaid payment system.

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  • 13. 

    LOW INCOME PATIENTS CAN BE COVERED BY WHAT TYPE OF INSURANCE?

    • MEDICAID

    • MEDICARE

    • TRI-CARE

    • BLUE CROSS/BLUE SHIELD

    Correct Answer
    A. MEDICAID
    Explanation
    Medicaid is a government-funded health insurance program that provides coverage for low-income individuals and families. It is specifically designed to assist those who have limited financial resources and cannot afford private health insurance. Therefore, Medicaid is the type of insurance that can cover low-income patients.

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  • 14. 

    AN AGENT OF AN INSURANCE COMPANY WHO SOLICITS OR INITIATES CONTRACTS FOR INSURANCE COVERAGE & SERVICES, AND IS THE POLICYHOLDER FOR THE INSURER IS CALLED?

    • INSURANCE AGENT

    • CLAIM REPRESENTATIVE

    • CARRIER

    • MEMBER PHYSICIAN

    Correct Answer
    A. INSURANCE AGENT
    Explanation
    An agent of an insurance company who solicits or initiates contracts for insurance coverage and services, and is the policyholder for the insurer is called an insurance agent.

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  • 15. 

    AN INJURY THAT PREVENTS A WORKER FROM PERFORMING ONE OR MORE OF THE REGULAR FUNCTIONS OF HIS JOB WOULD BE KNOW AS A?

    • PARTIAL DISABILITY

    • PERMANENT DISABILITY

    • TOTAL DISABILITY

    • RESULTANT DISABILITY

    Correct Answer
    A. PARTIAL DISABILITY
    Explanation
    Partial disability refers to an injury that hinders a worker from performing one or more regular functions of their job. This means that the worker is still able to perform some of their job duties, but not all of them. It indicates a limitation in their ability to work, but it is not a complete inability to work like in the case of total disability. Permanent disability refers to a long-term or permanent impairment that prevents a worker from performing their job duties. Resultant disability is not a commonly used term in this context.

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  • 16. 

    WHEN A PATIENT HAS HEALTH INSURANCE, THE PERCENTAGE OF COVERED SERVICES THAT IS THE RESPONSIBILITY OF THE PATIENT TO PAY IS KNOW AS?

    • COINSURANCE

    • PRE-DEFINED POLICY

    • COMPREHENSIVE

    • IN PERCENT POLICY

    Correct Answer
    A. COINSURANCE
    Explanation
    When a patient has health insurance, the percentage of covered services that is the responsibility of the patient to pay is known as coinsurance. Coinsurance is a cost-sharing arrangement between the insurance company and the patient, where the patient is required to pay a certain percentage of the total cost of a covered service, while the insurance company pays the remaining percentage. This helps to distribute the financial burden of healthcare expenses between the patient and the insurance provider.

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  • 17. 

    A DOCTOR WHO AGREES TO ACCEPT AN INSURANCE COMPANIES PRE-ESTABLISHED FEE AS THE MAXIMUM AMOUNT TO BE COLLECTED IS CALLED?

    • SUBSCRIBER

    • CLAIM REPRESENTATIVE

    • PARTICIPATING PHYSICIAN

    • ADJUSTER

    Correct Answer
    A. PARTICIPATING PHYSICIAN
    Explanation
    A doctor who agrees to accept an insurance company's pre-established fee as the maximum amount to be collected is called a participating physician. This means that the doctor has entered into a contract with the insurance company and agrees to provide services to their insured members at the agreed-upon fee schedule. By being a participating physician, the doctor is able to access a larger patient base and receive payment directly from the insurance company, rather than relying on the patient to pay out-of-pocket and seek reimbursement.

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  • 18. 

    THE INTERNATIONAL CLASSIFICATION OF DISEASE, 9TH REVISION, CLINICAL MODIFICATION (ICD-9-CM) IS USED TO CODE?

    • PROCEDURES

    • DIAGNOSES

    • SERVICES RENDERED

    • MEDICATIONS

    Correct Answer
    A. DIAGNOSES
    Explanation
    The International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) is used to code diagnoses. This coding system is used to classify and categorize diseases, injuries, and other health conditions for the purpose of medical billing, research, and statistical analysis. It provides a standardized way to record and communicate diagnoses, allowing healthcare providers to accurately document and report patient conditions. Using ICD-9-CM codes ensures consistency and uniformity in healthcare data, which is essential for effective healthcare management and analysis.

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  • 19. 

    A REQUEST FOR PAYMENT UNDER AN INSURANCE CONTRACTOR BOND IS CALLED A(N)?

    • INSURANCE APPLICATION

    • CLAIM

    • DUAL CHOICE REQUEST

    • TOTAL DISABILITY

    Correct Answer
    A. CLAIM
    Explanation
    A request for payment under an insurance contractor bond is called a claim. This is because when an insured party experiences a loss or damage covered by the insurance policy, they submit a claim to the insurance company to request compensation for the damages. The insurance company then investigates the claim and if it is found to be valid, they will provide the necessary payment to the insured party.

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  • 20. 

    A SUM OF MONEY PROVIDED IN AN INSURANCE POLICY, PAYABLE FOR COVERED SERVICES IS CALLED?

    • DEDUCTIBLE

    • BENEFITS

    • DUES PAYABLE

    • PREMIUM

    Correct Answer
    A. BENEFITS
    Explanation
    The correct answer is benefits because in an insurance policy, benefits refer to the sum of money provided by the insurance company to cover the cost of services that are included in the policy. This can include medical expenses, hospital stays, prescription medications, and other covered services. The benefits are the financial compensation that the policyholder receives from the insurance company when they use the services covered by their policy.

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  • 21. 

    A TYPE OF INSURANCE WHEREBY THE INSURED PAYS A SPECIFIC AMOUNT PER UNIT OF SERVICE & THE INSURER PAYS THE REST OF THE COST IS CALLED?

    • CO-PAYMENT

    • COORDINATION OF BENEFITS

    • DEDUCTIBLE

    • INDEMNITY

    Correct Answer
    A. CO-PAYMENT
    Explanation
    A type of insurance where the insured pays a specific amount per unit of service and the insurer pays the rest of the cost is called a co-payment. A co-payment is a fixed amount that the insured person must pay out of pocket for each medical service or prescription drug. It is a cost-sharing arrangement between the insured and the insurer, where the insured pays a portion of the cost and the insurer covers the remaining expenses. This helps to reduce the financial burden on the insured while still ensuring that they contribute to the cost of their healthcare.

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  • 22. 

    AN INTERVAL AFTER A PAYMENT IS DUE TO THE INSURANCE COMPANY IN WHICH THE POLICY HOLDER MAY MAKE PAYMENTS, AND STILL THE POLICY REMAINS IN EFFECT IS CALLED?

    • EXTENDED BENEFITS

    • GRACE PERIOD

    • COORDINATION OF BENEFITS

    • LAPSE TIME

    Correct Answer
    A. GRACE PERIOD
    Explanation
    A grace period is an interval after a payment is due to the insurance company in which the policyholder may make payments, and still, the policy remains in effect. During this period, the policyholder is given additional time to make the payment without any penalty or loss of coverage. It is a provision that allows for flexibility in payment deadlines, ensuring that the policyholder does not immediately lose coverage if they miss a payment.

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  • 23. 

    ONE WHO BELONGS TO A GROUP INSURANCE PLAN IS CALLED?

    • THIRD-PARTY PAYER

    • SUBSCRIBER

    • CARRIER

    • NO CORRECT ANSWER

    Correct Answer
    A. SUBSCRIBER
    Explanation
    A person who belongs to a group insurance plan is referred to as a subscriber. This term is commonly used in the insurance industry to denote an individual who is enrolled in a group insurance policy and is responsible for paying the premiums. The subscriber may also be the policyholder or the main contact person for the insurance plan.

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  • 24. 

    A CIVILIAN HEALTH & MEDICAL PROGRAM OF THE UNIFORM SERVICES IS CALLED?

    • TRI-CARE

    • MEDICARE

    • MEDICAID

    • WORKERS' COMPENSATION

    Correct Answer
    A. TRI-CARE
    Explanation
    The correct answer is TRI-CARE. Tri-Care is a civilian health and medical program of the Uniformed Services, which provides healthcare coverage to military personnel, their families, and retired military members. It is a comprehensive healthcare program that offers different plans and options to meet the specific needs of the beneficiaries. Tri-Care aims to ensure that eligible individuals have access to quality healthcare services and benefits.

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  • 25. 

    AN AGREEMENT BY WHICH A PATIENT ASSIGNS TO ANOTHER PARTY THE RIGHT TO RECEIVE PAYMENT FROM A THIRD PARTY FOR THE SERVICE THE PATIENT HAS RECEIVED IS CALLED?

    • ASSIGNMENT OF BENEFITS

    • COORDINATION OF BENEFITS

    • NON DUPLICATION OF BENEFITS

    • NO CORRECT ANSWER

    Correct Answer
    A. ASSIGNMENT OF BENEFITS
    Explanation
    An assignment of benefits is an agreement in which a patient transfers their right to receive payment for the services they have received to another party. This means that the payment from a third party, such as an insurance company, will be made directly to the party to whom the benefits have been assigned. This allows for a more efficient payment process and ensures that the healthcare provider receives the payment for the services rendered.

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  • 26. 

    PAYMENT MADE PERIODICALLY TO KEEP AN INSURANCE POLICY IN FORCE IS CALLED?

    • TIME LIMIT

    • PREMIUM

    • COINSURANCE

    • FEE-FOR-SERVICE

    Correct Answer
    A. PREMIUM
    Explanation
    A payment made periodically to keep an insurance policy in force is called a premium. This is the amount of money that an individual or business pays to an insurance company in exchange for coverage. The premium is typically paid on a monthly, quarterly, or annual basis, depending on the terms of the insurance policy. By paying the premium, the policyholder ensures that their insurance coverage remains active and that they will be protected in the event of a covered loss or claim.

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  • 27. 

    A RECORD OF DEBITS, CREDITS, AND BALANCES IS REFERRED TO AS A PATIENT'S?

    • SHEET

    • CHART

    • LEDGER

    • SLIP

    Correct Answer
    A. LEDGER
    Explanation
    A record of debits, credits, and balances is referred to as a patient's ledger. A ledger is a financial record that tracks all financial transactions, including debits (expenses) and credits (income), and keeps a running balance. In the context of a patient, a ledger would track the financial transactions related to their healthcare expenses, such as medical bills, insurance payments, and any outstanding balances.

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  • 28. 

    A SIGNATURE ON THE REVERSE SIDE OF A CHECK IS CALLED?

    • KITING

    • ENDORSEMENT

    • RECONCILIATION

    • SIGNATURE CARD

    Correct Answer
    A. ENDORSEMENT
    Explanation
    A signature on the reverse side of a check is called an endorsement. This is when the payee signs the back of the check to authorize the transfer of funds to another party. Endorsements can be blank, restrictive, or special, depending on the instructions provided by the payee. It is a common practice when depositing or cashing a check.

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  • 29. 

    A RIDER ADDED TO A POLICY TO PROVIDE ADDITIONAL BENEFITS FOR CERTAIN CONDITIONS IS CALLED?

    • HOSPITAL BENEFITS

    • DREAD DISEASE RIDER

    • PREEXISTING CONDITION

    • NO CORRECT ANSWER

    Correct Answer
    A. DREAD DISEASE RIDER
    Explanation
    A rider added to a policy to provide additional benefits for certain conditions is called a dread disease rider. This type of rider offers extra coverage specifically for serious illnesses or diseases such as cancer, heart attack, or stroke. It provides financial protection to the policyholder in the event they are diagnosed with one of the specified conditions, helping to cover medical expenses and other related costs.

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  • 30. 

    AN ORGANIZATION THAT OFFERS HEALTH INSURANCE AT A FIXED MONTHLY PREMIUM WITH LITTLE OR NO DEDUCTIBLE & WORKS THROUGH A PRIMARY CARE PROVIDER IS CALLED A(N)?

    • PREFERRED PROVIDER

    • HEALTH MAINTENANCE ORGANIZATION

    • MEMBER PHYSICIAN

    • PRIVATE HEALTH PROVIDER

    Correct Answer
    A. HEALTH MAINTENANCE ORGANIZATION
    Explanation
    A health maintenance organization (HMO) is an organization that offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider. In an HMO, individuals must choose a primary care provider who coordinates their healthcare and provides referrals to specialists if needed. The primary care provider acts as a gatekeeper, controlling access to healthcare services. This model emphasizes preventive care and focuses on managing and coordinating healthcare services for its members.

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  • 31. 

    INSURANCE PLANS THAT PAY A pHYSICIAN'S FULL CHARGE IF IT DOES NOT EXCEED HIS NORMAL CHARGE OR DOES NOT EXCEED THE AMOUNT NORMALLY CHARGED FOR THE SERVICE IS CALLED?

    • USUAL, CUSTOMARY AND REASONABLE

    • COMPREHENSIVE

    • DUAL CHOICE

    • NO CORRECT ANSWER

    Correct Answer
    A. USUAL, CUSTOMARY AND REASONABLE
    Explanation
    The correct answer is USUAL, CUSTOMARY AND REASONABLE. This term refers to insurance plans that will pay a physician's full charge if it does not exceed their normal charge or the amount normally charged for the service. This means that the insurance plan will cover the cost of the service as long as it falls within the usual and customary charges for that specific service.

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  • 32. 

    PAYMENT FOR HOSPITAL CHARGES INCURRED BY AN INSURED PERSON BECAUSE OF INJURY OR ILLNESS IS CALLED?

    • HOSPITAL BENEFITS

    • CATASTROPHIC HEALTH BENEFITS

    • EXTRA HELP BENEFITS

    • NO CORRECT ANSWER

    Correct Answer
    A. HOSPITAL BENEFITS
    Explanation
    Hospital benefits refer to the payment made by an insurance company to cover the charges incurred by an insured person due to injury or illness. This includes expenses such as hospitalization, surgeries, medications, and other medical services. It is a form of financial assistance provided to the insured individual to help them cover the costs associated with their healthcare needs.

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  • 33. 

    INSURANCE THAT IS MEANT TO OFFSET MEDICAL EXPENSES RESULTING FROM A CATASTROpHIC ILLNESS IS CALLED?

    • PRIMARY INSURANCE

    • MAJOR MEDICAL

    • WHOLE LIFE POLICY

    • COMPREHENSIVE

    Correct Answer
    A. MAJOR MEDICAL
    Explanation
    Major medical insurance is designed to provide coverage for extensive medical expenses that result from a catastrophic illness or injury. This type of insurance typically has higher deductibles and out-of-pocket costs, but offers more comprehensive coverage for hospital stays, surgeries, and other costly treatments. It is meant to protect individuals from the financial burden of significant medical expenses that could potentially bankrupt them.

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  • 34. 

    A PERSON WHO REPRESENTS EITHER PARTY OF AN INSURANCE CLAIM IS THE?

    • DOCTOR

    • ADJUSTER

    • PROVIDER

    • SUBSCRIBER

    Correct Answer
    A. ADJUSTER
    Explanation
    An adjuster is a person who represents either party of an insurance claim. They are responsible for investigating and evaluating the claim, determining the coverage, and negotiating a settlement. They act as a mediator between the insurance company and the policyholder or claimant, ensuring that the claim is handled fairly and in accordance with the terms of the insurance policy.

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  • 35. 

    THE __________ FORM IS USED BY NON-INSTITUTIONAL PROVIDERS & SUPPLIERS TO BILL MEDICARE, PART B COVERED SERVICES?

    • HCPA-1000

    • CPT

    • CMS-1500

    • UB92

    Correct Answer
    A. CMS-1500
    Explanation
    The CMS-1500 form is used by non-institutional providers and suppliers to bill Medicare for Part B covered services. This form is specifically designed for healthcare professionals and suppliers to submit claims for reimbursement for services rendered to Medicare beneficiaries. It includes all the necessary information such as patient demographics, diagnosis codes, procedure codes, and other relevant details required for Medicare billing purposes.

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  • 36. 

    IN INSURANCE CODING USING AN "E" CODE DESIGNATES?

    • A FACTOR THAT CONTRIBUTES TO A CONDITION OR DISEASE

    • CLASSIFICATION OF ENVIRONMENTAL EVENTS, SUCH AS POISONING

    • THE PRIMARY DIAGNOSIS

    • CANCERS

    Correct Answer
    A. CLASSIFICATION OF ENVIRONMENTAL EVENTS, SUCH AS POISONING
    Explanation
    Using an "E" code in insurance coding designates the classification of environmental events, such as poisoning. This means that when coding for insurance purposes, an "E" code is used to identify and classify incidents related to environmental events, specifically those involving poisoning. It helps in accurately categorizing and documenting these events for insurance claims and other purposes.

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  • 37. 

    A NOTICE OF INSURANCE CLAIM OR PROOF OF LOSS MUST BE FILED WITHIN A DESIGNATED __________ OR IT CAN BE DENIED?

    • WAITING PERIOD

    • POLICY DATE

    • TIME LIMIT

    • GRACE PERIOD

    Correct Answer
    A. TIME LIMIT
    Explanation
    A notice of insurance claim or proof of loss must be filed within a designated time limit or it can be denied. This means that there is a specific period of time within which the claim or proof of loss must be submitted in order for it to be considered valid. If the submission is made after the time limit has passed, the insurance company has the right to deny the claim.

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  • 38. 

    IN INSURANCE, GREATER COVERAGE OF DISEASES OR AN ACCIDENT, AND GREATER INDEMNITY PAYMENT IN COMPARISON WITH A LIMITED CLAUSE IS CALLED?

    • CO-PAYMENT

    • COMPREHENSIVE

    • DEDUCTIBLE

    • MAJOR MEDICAL

    Correct Answer
    A. COMPREHENSIVE
    Explanation
    Comprehensive coverage in insurance refers to a policy that provides extensive protection against a wide range of risks, including diseases and accidents. It offers greater coverage compared to a limited clause, meaning it covers more potential expenses and damages. This type of coverage often includes higher indemnity payments, meaning the insurance company will pay a larger portion of the costs incurred. Therefore, the term "comprehensive" accurately describes the concept of greater coverage and indemnity payment in comparison to a limited clause.

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  • 39. 

    HEALTH INSURANCE THAT PROVIDES PROTECTION AGAINST THE HIGH COST OF TREATING SEVERE OR LENGTHY ILLNESSES OR DISABILITIES IS CALLED?

    • CATASTROPHIC

    • SEVERE

    • THIRD-PARY PAYER

    • NO CORRECT ANSWER

    Correct Answer
    A. CATASTROPHIC
    Explanation
    Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called catastrophic. This type of insurance is designed to cover major medical expenses that exceed a certain threshold, such as a high deductible. It is meant to provide financial protection in case of a catastrophic event that could result in significant medical expenses.

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  • 40. 

    TO PREVENT THE INSURED FROM RECEIVING A DUPLICATE PAYMENT FOR LOSSES UNDER MORE THAN ONE INSURANCE POLICY IS CALLED?

    • FEE-FOR-SERVICE

    • HOSPITAL BENEFITS

    • COORDINATION OF BENEFITS

    • NON DUPLICATION BENEFITS

    Correct Answer
    A. COORDINATION OF BENEFITS
    Explanation
    Coordination of benefits is the correct answer because it refers to the process of preventing the insured from receiving duplicate payments for losses under multiple insurance policies. This is done to ensure that the insured does not receive more than the actual amount of the loss. By coordinating benefits, insurance companies work together to determine the primary and secondary coverage for a claim, avoiding overpayment and reducing the potential for fraud or abuse.

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  • 41. 

    THE NUMBER ON THE EMPLOYEES WITHHOLDING EXEMPTION CERTIFICATE IS?

    • W-2

    • W-4

    • 1040

    • W-3

    Correct Answer
    A. W-4
    Explanation
    The correct answer is W-4. The W-4 form is used by employees to provide their employer with information about their tax withholding preferences. It determines how much federal income tax should be withheld from their paychecks. The W-2 form, on the other hand, is a summary of an employee's earnings and tax withholdings for the year, which is provided by the employer to the employee and the IRS. The 1040 form is the individual tax return form that taxpayers use to file their annual income tax returns. The W-3 form is a transmittal form that employers use to report employee wage and tax information to the Social Security Administration.

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  • 42. 

    FICA PROVIDES BENEFITS FOR?

    • MEDICARE

    • SOCIAL SECURITY

    • OLD AGE

    • AID TO DEPENDENT CHILDREN

    Correct Answer
    A. SOCIAL SECURITY
    Explanation
    FICA provides benefits for Social Security. FICA stands for Federal Insurance Contributions Act, which is a law that requires employers and employees to contribute a portion of their earnings to fund Social Security and Medicare. Social Security provides benefits to retired workers, disabled individuals, and the dependents of deceased workers. Therefore, FICA contributions help fund the Social Security program and provide benefits to individuals in need.

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  • 43. 

    A SKILLED NURSING FACILITY FOR PATIENTS RECEIVING SPECIALIZED CARE AFTER DISCHARGE FROM A HOSPITAL IS CALLED?

    • EXTENDED CARE FACILITY

    • POST CARE FACILITY

    • NURSING HOME

    • NO CORRECT ANSWER

    Correct Answer
    A. EXTENDED CARE FACILITY
    Explanation
    An extended care facility is a skilled nursing facility that provides specialized care to patients after they are discharged from a hospital. This type of facility offers medical services and assistance with daily activities to help patients recover and regain their independence. It is different from a nursing home, which typically provides long-term care for individuals who are unable to live independently. A post care facility is not a commonly used term in the healthcare industry.

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  • 44. 

    E/M CODES ARE LOCATED IN THE __________ MANUAL?

    • CPT

    • ICD-9-CM

    • ICD-10-CM

    • HCPC

    Correct Answer
    A. CPT
    Explanation
    The correct answer is CPT. E/M codes, which stand for Evaluation and Management codes, are located in the CPT (Current Procedural Terminology) manual. This manual is published by the American Medical Association and is widely used for reporting medical procedures and services. The CPT manual provides a standardized system for coding and billing for medical services, including E/M codes which are used to describe the level of complexity and time spent during patient encounters.

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  • 45. 

    THE REFERENCE PROCEDURAL CODE BOOK THAT USES A NUMBERING SYSTEM DEVELOPED BY THE AMA IS CALLED A(N)?

    • REFERENCE MANUAL

    • CUURENT PROCEDURE TERMINOLOGY

    • INSURANCE CLAIM MANUAL

    • MANUAL FOR CURRENT PROCEDURES

    Correct Answer
    A. CUURENT PROCEDURE TERMINOLOGY
    Explanation
    The correct answer is "CUURENT PROCEDURE TERMINOLOGY." This is because the question asks for the name of the reference procedural code book that uses a numbering system developed by the AMA. Current Procedure Terminology (CPT) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services. It is published by the American Medical Association (AMA) and is widely used in medical billing and coding.

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  • 46. 

    __________ IS A METHOD USED FOR DETERMINING WHETHER A PARTICULAR SERVICE OR PROCEDURE IS COVERED UNDER A PATIENT'S POLICY?

    • INFORMED CONSENT

    • PREAUTHORIZATION

    • PRE-CERTIFICATION

    • NO CORRECT ANSWER

    Correct Answer
    A. PRE-CERTIFICATION
    Explanation
    Pre-certification is a method used for determining whether a particular service or procedure is covered under a patient's policy. It involves obtaining approval from the insurance company before the service or procedure is performed, ensuring that the patient's policy will cover the costs. This process helps prevent unexpected expenses for the patient and allows the healthcare provider to confirm coverage and receive payment for services rendered.

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  • 47. 

    AS PART OF THE OFFICE BOOKKEEPING PROCEDURES, THE pHYSICIAN'S BANK STATEMENTS SHOULD BE RECONCILED WITH THE?

    • DAILY LEDGER

    • BUSINESS LEDGER

    • PERSONAL LEDGER

    • CHECKBOOK

    Correct Answer
    A. CHECKBOOK
    Explanation
    As part of the office bookkeeping procedures, the physician's bank statements should be reconciled with the checkbook. This means that the transactions recorded in the checkbook should be compared and matched with the transactions listed in the bank statements. By doing so, any discrepancies or errors can be identified and corrected, ensuring that the financial records are accurate and up to date. Reconciling the bank statements with the checkbook is an important step in maintaining the integrity of the office's financial records.

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  • 48. 

    BENEFITS THAT ARE MADE IN THE FORM OF CASH PAYMENTS ARE KNOWN AS?

    • INDEMNITIES

    • DEDUCTIBLES

    • MEDICAL CO-PAYS

    • CASH ADVANCES

    Correct Answer
    A. INDEMNITIES
    Explanation
    Cash payments that are made as benefits are known as indemnities. An indemnity is a form of compensation or reimbursement provided in cash. It is usually given to cover losses or damages incurred by an individual or organization. In the context of benefits, indemnities refer to the monetary payments made to individuals as part of their compensation package or insurance coverage. This can include cash payments for medical expenses, disability benefits, or other forms of financial assistance. Indemnities provide individuals with direct financial support and flexibility to use the funds as needed.

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  • 49. 

    THE TRI-CARE FISCAL YEAR IS FROM?

    • JANUARY 1 TO DECEMBER 31

    • OCTOBER 1 TO SEPTEMBER 1

    • OCTOVER 1 TO SEPTEMBER 30

    • JULY 1 TO JUNE 31

    Correct Answer
    A. OCTOVER 1 TO SEPTEMBER 30
    Explanation
    The Tri-Care fiscal year is from October 1 to September 30. This means that the fiscal year begins on October 1st and ends on September 30th of the following year. This time frame is commonly used for financial reporting and budgeting purposes in various organizations and government agencies.

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Quiz Review Timeline (Updated): Mar 20, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 20, 2015
    Quiz Created by
    Mikeba Hill
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