Blue
The amount of money paid to keep an insurance policy in force is the
A. Premium
B. Deductible
C. Co-pay
D. Co-Insurnace
A. Premium
Health insurance designed for military dependents and retired military personnel is called
A. CHAMPVA
B. TRICARE
B. TRICARE
A certain percentage of the allowed amount that policyholder is responsible for is
A. Premium
B. Deductible
C. Co-pay
D. Co-Insurance
D. Co-Insurance
Medigap policies cover which of the following
A. Medicare deductible
B. Medicare co insurance
C. Services not covered under Medicare
D. All the above
D. All the above
Which of the following expenses would be paid by Medicare Part B
A. Inpatient
B. Hospice Services
C. Physicians office visits
D. Home Healthcare charges
C. Physicians office visits
An order from a primary care provider for the patient to see a specialist is
A. Pre-authorization
B. Policy
C. Referral
D. Health insurance exchange
C. Referral
A. Traditional Health Insurance
B. Managed care organizations
C. Medicare
D. Medicaid
A. Traditional Health Insurance
In some managed care plans referrals to a specialist must be approved by the
A. Beneficiary
B. Gatekeeper
C. Third-party administrator
D. Policyholder
B. Gatekeeper
The amount of money the policy holder pays per claim before the insurance company will pay on the claim is known as the
A. Exclusion
B. Premium
C. Deductible
D. Remittance
C. Deductible
Which of the following letters in the ICD 10 CM is reserved by the World Health Organization to assign new diseases with uncertain etiology
A. U
B. X
C. Y
D. Z
A. U
A payment method in which providers are paid for each individual enrolled in a plan, regardless of whether the person sees the provider that month, is called a ______ plan
A. Capitation
B. Self-insured
C. Managed care
D. Fee-for-service
A. Capitation
Which of the following MCO's typically has/have the lowest monthly premiums with lower patient financial responsibility?
A. PPO
B.HMO
B.HMO
The physician who enters into a contract with an insurance company and agrees to certain rules and regulations is called a _____ provider
A. Participating
B. Paying
C. Physician
D. None of the above
A. Participating
The signs and symptoms of a diseases are its
A. Manifestations
B. Symptoms
C. Prognosis
D. Etiology
A. Manifestations
An approved list of physicians, hospitals, and other providers is a
Provider Network
Which of the following managed care plans require preauthorization for medical services such as surgery?
A. HMO
B. PPO
C. EPO
D. All the above
D. All the above
The abbreviation that is the equivalents of unspecified is
A. NEC
B. POS
C. NOS
D. DOS
C. NOS
Service provided to stop certain conditions from occurring or to lead to an early diagnosis are considered
Preventive
A review of individual cases by a committee to make sure that services are medically necessary is called a(n).
A. Credentialing
B. Peer review
C. Utilization review
D. Audit committee review
C. Utilization review
At time the MA must code an _____ if the physician is not yet sure of the diagnosis
A. Manifestation
B. Symptoms
C. Prognosis
D. Etiology
B. Symptoms
To make repayment to for expense or loss incurred describes which of the following terms
A. Reimbursement
B. Diagnosis
C. Abstract
D. Medically Necessary
A. Reimbursement
The study of the causes or origin of diseases describes which of the following terms?
A. Etiology
B. Mortality
C. Sequela
A. Etiology
An abnormal condition resulting from a previous disease describes which of the following terms
A. Epidemiological
B. Etiology
C. Mortality
D. Sequela
D. Sequela
The code HIV indicates which of the following ?
A. HIV virus is present
B. Probable case of HIV
C. Suspected case of HIV
A. HIV virus is present
When performing diagnostic coding you should start in looking in the Alphabetic Index which main terms appear in bold
True or False
True