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CPAT Patient Access Services for PFS
- 1.The two main governing bodies effecting healthcare change are:
- A.
CMS and AHCA
- B.
CMS and FDA
- C.
CMS and DHHS
- D.
DHHS and CDC
- 2.The DHHS include all of the programs listed below except:
- A.
Medicare
- B.
CMS
- C.
Child Support Enforcement
- D.
AFDC
- 3.CMS is the acronym for:
- A.
Centers for Medicaid and Medicare Services
- B.
Center for Medicaid and State Operations
- C.
Center for Medicare Services
- D.
Centers for Medicare and Medicaid Services
- 4.Medicare is also know as:
- A.
Title XVIII
- B.
Itle XVII
- C.
Title XIII
- D.
Title XIX
- 5.Medicare has how many parts:
- A.
1
- B.
2
- C.
3
- D.
4
- 6.Medicare provides insurance to:
- A.
People with end stage renal disease (ESRD requiring dialysis or a kidney transplant)
- B.
People who are 65 years or older
- C.
People who are disabled
- D.
All of the above
- 7.Medicare Part B pays for all of the following except:
- A.
Physician services
- B.
Hospice care
- C.
Outpatient hospital services
- D.
Medical equipment and supplies
- 8.Medicare Part A provides coverage for which services except:
- A.
Home health services
- B.
Skilled nursing facilities
- C.
Preventative care
- D.
Inpatient hospital services
- 9.Medicaid is also known as:
- A.
Title XVIII
- B.
Title XVII
- C.
Title XIII
- D.
Title XIX
- 10.Medicaid is a health insurance program that covers which people:
- A.
People who are 65 years and older
- B.
Certain low-income people
- C.
People who are disabled
- D.
People with ESRD that requiring dialysis or a kidney transplant
- 11.Medicaid is funded and administered through:
- A.
State and federal funding
- B.
Federal funding
- C.
State funding
- D.
Self funded
- 12.The State Children’s Health Insurance Program (SCHIP) is also known as:
- A.
Title XXI
- B.
Title XVII
- C.
Title XIII
- D.
Title XIX
- 13.All states must cover the services listed below except:
- A.
Inpatient and outpatient hospital services
- B.
Laboratory and X-ray services
- C.
Dental care
- D.
Well baby/child care
- 14.Which legislation enacted the most significant changes to the Medicare an Medicaid Programs since their inception?
- A.
TEFRA
- B.
BBA
- C.
COBRA
- D.
DEFRA
- 15.Which act removed the age limit previously imposed on a spouse for health plan coverage?
- A.
TEFRA
- B.
BBA
- C.
COBRA
- D.
DEFRA
- 16.The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 required what:
- A.
Required EGHP with 50 or more employees to be primary to Medicare
- B.
Required EGHP with 15 or more employees to be primary to Medicare
- C.
Required EGHP with 40 or more employees to be primary to Medicare
- D.
Required EGHP with 20 or more employees to be primary to Medicare
- 17.Which act provided for the Resource Based Relative Value Scale?
- A.
OBRA of 1986
- B.
COBRA of 1985
- C.
OBRA of 1989
- D.
DEFRA of 1984
- 18.The RBRVS consist of which major elements?
- A.
RVU
- B.
MVPS
- C.
Limiting charge
- D.
All of the above
- 19.The Relative Value Unit (RVU) is comprised of all of the following except:
- A.
Work required
- B.
Limiting charge
- C.
Practice expense
- D.
Malpractice insurance
- 20.The limiting charge is what percentage of the fee schedule amount?
- A.
120%
- B.
150%
- C.
115%
- D.
125%
- 21.HIPAA is the acronym for:
- A.
Health Information Portable and Accountable Act
- B.
Health Insurance Portable and Accountable Act
- C.
Health Insurance Portability and Accountability Act
- D.
Health Information Portability and Accountability Act
- 22.HIPAA’s key provisions include:
- A.
Guaranteed access to health insurance for small businesses
- B.
Guaranteed renewal of insurance regardless of health status
- C.
Limitations on pre-existing conditions
- D.
All of the above
- 23.All of the following are parts to HIPAA’s Administrative Simplification except:
- A.
NPI
- B.
Health savings accounts
- C.
Security requirements
- D.
Electronic transactions and code set standards
- 24.The National Provider Identifier (NPI) consists of how many digits?
- A.
10
- B.
6
- C.
5
- D.
8
- 25.ANSI X12 837I is the transaction standard for which of the following:
- A.
Healthcare claims status
- B.
Eligibility for a health plan
- C.
Institutional claim
- D.
None of the above
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