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A change to a patients account whether positve or negative.
a. adjustment
b. withhold
c. removal
d. audit
a. adjustment
The coinsurance for Medicare Part B is
a. 75/25
b. 80/20
c. 20/80
d. 25/75
b. 80/20
A list of drugs that are covered under an insurance plan is called the
a. credible
b. formulary
c. pharmacy benefit
d. tier
b. formulary
Inpatient Hospital benefits are provided under
a. medicare part A
b. medicare part B
c. medicare part C
d. medicare part D
a. medicare part A
How often do open enrollment periods usually occur?
a. once a year
b. twice per year
c. one per month
d. every other year
a. once per year
Which Medicare Part provides coverage for durable medical equipment?
a. medicare part A
b. medicare part B
c. medicare part C
d. medicare part D
b. medicare part B
Medicaid beneficiaries must meet
a. both minimum federal requirements and any additional state requirements.
b. either the federal or state requirements.
c. state requirements.
d. minimum federal requirements.
a. both minimum federal requirements and any additional state requirements.
Which of the following type of plan do employers or employee organizations offer to their employees?
A. GHP
B. IHP
C. URO
D. MCO
A. GHP
Medigap insurance plans can be purchased as a supplement for individuals enrolled in.
A. the Original Medicare Plan.
B. any type of Medicare plan.
C. all types of health insurance plans.
D. disability insurance
A. The Original Medicare Plan.
Third-party claims administrators(TPA)are classified as
A. a managing company for IHPs.
B. a separate company, often a managed care organization or insurance carrier.
C. Treatment, Payment and Audits
D. a medical practice tasked with handling collections & claims processing.
B. a separate company, often a managed care organization or insurance carrier.
The amount of time that must pass before an employee can enroll in a health plan is called
A. LATER PERIOD
B. WAITING PERIOD
C. HOST PLAN
D. OPEN ENROLLMENT
B. WAITING PERIOD
The Temporary Assistance for Needy Families provides which of the following?
A. FREE MEDICAL SUPPLIES
B. FINANCIAL ASSISTANCE TO BENEFICIARIES
C. FREE PRESCRIPTIONS TO BENEFICIARIES
D. transportation to medical appointments
B. FINANCIAL ASSISTANCE TO BENEFICIARIES
A consumer-driven health plan combines a savings option and what kind of health plan?
A. FEE-FOR-SERVICE
B. EPISODE-OF-CARE
C. LOW DEDUCTIBLE
D. HIGH DEDUCTIBLE
D. HIGH DEDUCTIBLE
What is an MBI?
A. Medicaid Beneficiary Indentifier
B. Medicaid Billing Indicator
C. Medicare Billing Indicator
D. Medicare Beneficiary Indentifier
D. Medicare Beneficiary Indentifier
Anyone over age 65 who receives Social Security benefits is automatically
A. Neither enrolled in Medicare Part A nor eligible for Medicare Part B.
B. enrolled in Medicare Part A.
C. enrolled in Medicare Part A and eligible for Medicare Part B.
D. eligible for Medicare Part B.
C. enrolled in Medicare Part A and eligible for Medicare Part B.
Explain the benefit that COBRA offers to employees who are leaving a job.
A. the right to freedom from a maximum benefit limit
B. the right to parity in selecting their next health plan
C. the right to skip the waiting period
D. the right to pay for coverage for 18 months
D. the right to pay for coverage for 18 months
What type of private payer offers lower costs, but also has stringent guidelines & the narrowest choice of providers?
A. indemnity plans
B. HMO's
C. point-of-service (POS) plans
D. preferred provider organizations (PPOs)
B. HMO's
A government-regulated marketplace offering insurance plans to individuals is known as.
A. HIX
B. IHP
C. EHB
D. HOST PLAN
A. HIX
Medicare Advantage is under which part of Medicare?
A. MEDICARE PART A
B. MEDICARE PART B
C. MEDICARE PART C
D. MEDICARE PART D
C. MEDICARE PART C
A guarantor is always 18 yrs old old or older except when.
THEY HAVE MEDICAID
Form used for non-covered Medicare services
A. ABN
B. ANB
C. BAN
D. BNA
A. ABN
What is the criteria to be eligible for Medicare
AGE
DISABILITY
ESRD
Organization that maintains Health and safety in the workplace
A. OSHA
B. JACHO
C. WORKER'S COMPENSATION
D. SECURITY
A. OSHA
The act that was put into place to ensure all Americans had access to insurance at a reasonable price
ACA
OBAMA CARE
AFFORDABLE CARE ACT
Another name for medicare policy number is
A. MBI
B. SSI
C. SSN
D NPI
A. MBI