17.1
17.3 ,17.4
17.5
17.6
17.7+.8
100

what other people can a health plan cover?

Spouse and children

100
  1. What year did MACRA require CMS to provide new medicare cards without ssn.

2019

100
  1. What are 3 patient information that you need to obtain?

  1. Current employer

  2. Employer address and telephone 

  3. Insurance

  4. Patient signature on insurance release info form 

  5. Patients signature of assessment of benefit form

100

Medical healthcare claims are not only records, but a clear form of___

Communication 

100
  1. What is the name of the group that standardizes and formats medical billing documents for practices?

Clearhouse

200

Are dental and eye examinations always covered with insurance?

no

200

Is Medicaid an insurance program,

It is a cost assistance program.

200

What are 3 patient facts you need to verify?

  1. Patient legal name

  2. Current home address

  3. Current telephone number

200

Before the claims are processed, they must be “clean” -free from:

errors

200
  1. What does DDE stand for?

  1. Direct Data Entry

300

What is the healthcare that Obama made called and what is it for?

Answer:Name: Obama care.Insurance coverage to all americans.

300

What does CHAMPVA stand for.

  1. Civilian Health and Medical program of the Veterans Administration 

300

What is the first thing the medical assistant needs to do to make sure a patient is eligible for service?

  1. Verify patients personal insurance info

300

The term given to the insurance when they are willing to finance a claim within a set amount of days ;ex: 60-90 days.

Date of Service

300
  1. Give an example of something HIPAA requires for practice security:

  1. Access control

  2. Passwords

  3. Logs for safekeeping

  4. Backups

  5. Security policies to handle violations

400

What are the two major types of health plans?

What are the two major types of health plans?

400

What is the 3 step payment method.

  1. Allowed Charges, Contracted fee schedule, capitation. Allowed charges, The maximum amount of payers will pay. 

400

What are the 2 ways to obtain prior authorization?

  1. Website

  2. Phone

400

The __####__ claim set new standards that regulate the electronic transmission of specific health care transactions.

5010 claim 

400
  1. What do insurers check to justify treatment?

Benefits

500

Who does disability insurance cover?

Answer:Covers people who are injured or disabled for non work reasons.



500
  1. What is workers com used for.

This is for people hurt on the job

500

What is one thing that the medical assistant needs to do when they receive the super bill?

  1. Prepare and transmit a healthcare claim to the insurance company in behalf of patient 

  2. Accept payment from the patient for the full amount and the patient can submit a claim to the insurance carrier for reimbursement.

  3.  Accept insurance copayment and coinsurance from patients.



500
  1. What are the 3 main pieces of Payment Advice?

  1. RA - remittance advice

  2. EOP - explanation of payment

  3. EOB - explanation of benefits

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