Question 1

What two pieces of equipment are needed to use medical coding to reflect care provided?

Accepted Answer

A)   Patient encounter form and patient record
B)   Form CMS-1500 and patient record
C)   Patient encounter form and CPT manual
D)   CPT manual and patient recordE) B) and D)
F) None of the above

Question 2

What is one of the common errors found on a claims form?

Accepted Answer

A)   Assignment of incorrect codes to diagnoses or treatments
B)   Including too much patient information
C)   Including specific and accurate information
D)   Assigning the primary concern code first and all others secondaryE) B) and D)
F) All of the above

Question 3

Which of the following terms refers to the monetary compensation for medical care provided?

Accepted Answer

A)   Documentation
B)   Diagnostic coding
C)   Reimbursement
D)   BillingE) A) and B)
F) All of the above C

Question 4

What is the primary goal of a managed care system?

Accepted Answer

A)   Provide comprehensive healthcare
B)   Help patients obtain routine care
C)   Reduce costs
D)   Provide preventative servicesE) C) and D)
F) A) and B)

Question 5

Which of the following terms means "A fixed fee that is received from the payment each time care is provided"?

Accepted Answer

A)   Co-pay
B)   Co-insurance
C)   Deductible
D)   ReimbursementE) All of the above
F) B) and C)

Question 6

Which of the following are accounts that can be used to pay for medical services not covered by the health-insurance provider?

Accepted Answer

A)   HSA and FSA
B)   CDHP
C)   PPO
D)   HMOE) B) and D)
F) A) and D)

Question 7

What is the term that refers to the act of an insurance provider only paying for certain claim codes and ignoring others?

Accepted Answer

A)   Unbundling
B)   Bundling
C)   Downcoding
D)   UpcodingE) A) and B)
F) A) and C)

Question 8

The healthcare common procedure coding system (HCPCS)  is a set of codes that standardizes the identification of medical:

Accepted Answer

A)   Services, supplies, and equipment
B)   Equipment, prosthetics, orthotics, and supplies
C)   Medications
D)   FacilitiesE) B) and D)
F) B) and C)

Question 9

Which of the following insurance plans requires individuals to select a primary care provider (PCP) ?

Accepted Answer

A)   Consumer-driven health plan
B)   Managed care
C)   Health maintenance organization
D)   Preferred-provider organizationE) A) and B)
F) None of the above C

Question 10

Which of the following groups will Medicare NOT provide health insurance for?

Accepted Answer

A)   People over 65
B)   People who are diagnosed with ESRD
C)   People who are diagnosed with CPOD
D)   People who are disabledE) A) and B)
F) A) and C)

Question 11

Which of the following is a mechanism that pays medical providers for their services?

Accepted Answer

A)   Private health-insurance programs
B)   Consumer-driven health plans
C)   Government health coverage plans
D)   All of the aboveE) A) and C)
F) B) and C)

Question 12

Which of the following are symptoms of diabetes?

Accepted Answer

A)   Polydipsia
B)   Polyuria
C)   Polyphagia
D)   All of the aboveE) A) and B)
F) A) and C)

Question 13

Which of the following is a privately owned and managed health-insurance provider?

Accepted Answer

A)   Commercial insurance
B)   Managed care
C)   Health maintenance organization
D)   Preferred provider organizationE) B) and C)
F) None of the above

Question 14

What year will most changes outlined in the Affordable Care Act begin?

Accepted Answer

A)   2012
B)   2014
C)   2010
D)   2015E) All of the above
F) B) and C)

Question 15

Which of the following is NOT a goal of the Affordable Care Act of 2010?

Accepted Answer

A)   Expand coverage
B)   Improve access to health care
C)   Decrease deductibles
D)   Make insurance companies more accountable for their coverage decisionsE) A) and B)
F) All of the above C

Question 16

The standard medical insurance claim form submitted by most office practices and accepted by Medicare, Medicaid, and other insurance providers is a(n) :

Accepted Answer

A)   CMS-1400
B)   CMS-1500
C)   CMS-1450
D)   UB-04E) A) and B)
F) A) and C)

Question 17

Which of the following terms means "The amount an individual must pay before the insurance provider will begin paying for services"?

Accepted Answer

A)   Co-pay
B)   Deductible
C)   Co-insurance
D)   Annual premiumE) A) and B)
F) B) and C)

Question 18

According to requirements from the Health Insurance Portability and Accountability Act, patients must have a _________ on file for the provider to release data to the insurance company for benefit or payment information.

Accepted Answer

A)   Record
B)   Address
C)   Signature
D)   Phone numberE) A) and C)
F) A) and B)

Question 19

_________ insurance protects people from the high costs associated with medical care.

Accepted Answer

A)   Co-
B)   Network
C)   Health
D)   PersonalE) A) and D)
F) C) and D)

Question 20

_______ is the process of assigning alphanumeric designations to diagnoses, procedures, and services.

Accepted Answer

A)   Reimbursement
B)   Coding
C)   Insured
D)   CategorizingE) None of the above
F) A) and B)

Exam 18: Medical Insurance and Coding

What two pieces of equipment are needed to use medical coding to reflect care provided?

Correct AnswerverifiedShow Answer

What is one of the common errors found on a claims form?

Correct AnswerverifiedShow Answer

Which of the following terms refers to the monetary compensation for medical care provided?

Correct AnswerverifiedC

What is the primary goal of a managed care system?

Correct AnswerverifiedShow Answer

Which of the following terms means "A fixed fee that is received from the payment each time care is provided"?

Correct AnswerverifiedShow Answer

Which of the following are accounts that can be used to pay for medical services not covered by the health-insurance provider?

Correct AnswerverifiedShow Answer

What is the term that refers to the act of an insurance provider only paying for certain claim codes and ignoring others?

Correct AnswerverifiedShow Answer

The healthcare common procedure coding system (HCPCS) is a set of codes that standardizes the identification of medical:

Correct AnswerverifiedShow Answer

Which of the following insurance plans requires individuals to select a primary care provider (PCP) ?

Correct AnswerverifiedC

Which of the following groups will Medicare NOT provide health insurance for?

Correct AnswerverifiedShow Answer

Which of the following is a mechanism that pays medical providers for their services?

Correct AnswerverifiedShow Answer

Which of the following are symptoms of diabetes?

Correct AnswerverifiedShow Answer

Which of the following is a privately owned and managed health-insurance provider?

Correct AnswerverifiedShow Answer

What year will most changes outlined in the Affordable Care Act begin?

Correct AnswerverifiedShow Answer

Which of the following is NOT a goal of the Affordable Care Act of 2010?

Correct AnswerverifiedC

The standard medical insurance claim form submitted by most office practices and accepted by Medicare, Medicaid, and other insurance providers is a(n) :

Correct AnswerverifiedShow Answer

Which of the following terms means "The amount an individual must pay before the insurance provider will begin paying for services"?

Correct AnswerverifiedShow Answer

According to requirements from the Health Insurance Portability and Accountability Act, patients must have a _________ on file for the provider to release data to the insurance company for benefit or payment information.

Correct AnswerverifiedShow Answer

_________ insurance protects people from the high costs associated with medical care.

Correct AnswerverifiedShow Answer

_______ is the process of assigning alphanumeric designations to diagnoses, procedures, and services.

Correct AnswerverifiedShow Answer

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C

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