Office Medical Terminology Pt1

10 Questions | Total Attempts: 178

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Office Medical Terminology Pt1 - Quiz

This quizz is designed to help with medical terminology that will help you when you are dealing with insurance companies trying to get claims paid.


Questions and Answers
  • 1. 
    The Birthday Rule states that.......
    • A. 

      Parent whos birthday is closest day of the child

    • B. 

      Parent whose date of birth (year and month) is earlier is the primary plan for dependent.

    • C. 

      Parent whose date of birth (month and day) falls earlier in the calendar year is the primary plan for dependent.

  • 2. 
    Part A Medicare covers patients for
    • A. 

      Inpatient and limited skilled nursing facility services.

    • B. 

      Inpatient hospital, home health, hospice, and limited skilled nursing facility services.

    • C. 

      Physician sevices, medical supplies, and other outpatient treatment.

    • D. 

      Physician services and home health care

  • 3. 
    Part B Medicare covers patients for
    • A. 

      Physician services, medical supplies and other outpatient treatments

    • B. 

      Inpatient hospital, home health, hospice and limited skilled nursing facility services.

    • C. 

      Inpatient and limited skilled nursing facility services.

    • D. 

      Physician services and home health care

  • 4. 
    Part B Medicare Beneficiaries are responsible for
    • A. 

      Deductibles and co-pays

    • B. 

      Monthly premiums, co-payments, deductibles and balance billing.

  • 5. 
    Part A Beneficiaries are responsible for
    • A. 

      Monthly premiums, co-payments, deductibles and balance billing.

    • B. 

      Deductibles and co-pays

  • 6. 
    Coverage for treatment obtained from a non-participating provider. Typically, it requires payment of a deductible and higher co-payments and co-insurance than for treatment from a participating provider. Insurer may also deny entire bill.
    • A. 

      Out of Pocket Costs (OOPs)

    • B. 

      Out of Network (OON)

    • C. 

      Pre-Admission Certification (PAC)

  • 7. 
    Medicaid is (pick two anwers)
    • A. 

      A jointly-funded, federal and state health insurance program

    • B. 

      A federal funded health insurance program

    • C. 

      A state health insurance program

    • D. 

      Only for people under 65, low income, and/or disabled.

    • E. 

      For certain low-income and needy people including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments

  • 8. 
    A portion of the covered expenses (typically $100, $200 or $500) that an insured individual must pay before insurance coverage with co-insurance goes into effect. They are usually standard in many policies, and are usually based on a calendar year.
    • A. 

      Co-insurance

    • B. 

      Monthly Premiums

    • C. 

      Deductible

  • 9. 
    A type of cost sharing where the beneficiary and insurance provider share payment of the approved charge for covered services in a specidied ratio after payment of the deductible by the insured. For example, the insurance company agrees to pay 80% of covered charges and the individual picks up 20%.
    • A. 

      Deductible

    • B. 

      Co-insurance

    • C. 

      Monthly Premiums

  • 10. 
    A set fee the member pays to providers at the time services are provided. applied to emergency room visits, hospital admissions, office visits, etc. The cost is usually minimal. The patient should be aware of this amount prior to services being rendered.
    • A. 

      Co-insurance

    • B. 

      Deductible

    • C. 

      Co-payment

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