ACG CXA EXAM SCRIPT COMPLETE
QUESTIONS AND ANSWERS VERIFIED FULL
SOLUTION GRADED A+
⩥ Allowed Amount.
Answer: The maximum amount a third-party payer will pay for
a particular procedure or service
⩥ Copayment.
Answer: a small fixed fee paid by the patient at the time of an
office visit
⩥ Coinsurance.
Answer: a provision under which both the insured and the
insurer share the covered losses, typically 80:20
⩥ deductible.
Answer: specific amount of money a patient must pay out of
pocket before the insurance carrier begins paying
⩥ Explanation of Benefits.
,Answer: a form created by the insurance company to explain
what charges were covered, denied, or need more documentation
based on the claims submitted by the physician's office
⩥ Participating provider (PAR).
Answer: Providers who agree to write off the difference between
the amount charged by the provider and the approved fee
established by the insurer
⩥ Medicare.
Answer: A federal program of health insurance for persons 65
years of age and older by Part A (hospitalization) or Part B
(routine medical office visits)
⩥ Tricare.
Answer: U.S. government health insurance plan for all military
personnel
⩥ CHAMPVA.
Answer: covers surviving spouses and dependent children of
veterans who died as a result of service-related disabilities
,⩥ Medicaid.
Answer: provides health insurance to the medically indigent
population through a cost-sharing program between federal and
state governments for those who meet specific eligibility criteria
⩥ Managed Care.
Answer: is an umbrella term for plans that provide health care in
return for preset scheduled payments and coordinated care
through a defined network of providers and hospitals
⩥ CMS-1500 form.
Answer: Standard insurance form used by all government and
most commercial insurance payers.
- 33 blocks
- divided into three section
⩥ CMS-1500 Section 1.
Answer: Carrier Block: contains the address of the insurance
carrier and is located at the top of the form
⩥ CMS-1500 Section 2.
, Answer: Patient/insured section: contains information about the
patient or insured; includes boxes 1-13
⩥ CMS-1500 Section 3.
Answer: Physician/Supplier Section: contains information about
the physician or supplier: boxes 14-33
⩥ Supine Position.
Answer:
⩥ Dorsal Recumbent Position.
Answer:
⩥ Sims' Position.
Answer:
⩥ Knee-elbow position.
Answer:
⩥ Fowler's Position.
Answer:
QUESTIONS AND ANSWERS VERIFIED FULL
SOLUTION GRADED A+
⩥ Allowed Amount.
Answer: The maximum amount a third-party payer will pay for
a particular procedure or service
⩥ Copayment.
Answer: a small fixed fee paid by the patient at the time of an
office visit
⩥ Coinsurance.
Answer: a provision under which both the insured and the
insurer share the covered losses, typically 80:20
⩥ deductible.
Answer: specific amount of money a patient must pay out of
pocket before the insurance carrier begins paying
⩥ Explanation of Benefits.
,Answer: a form created by the insurance company to explain
what charges were covered, denied, or need more documentation
based on the claims submitted by the physician's office
⩥ Participating provider (PAR).
Answer: Providers who agree to write off the difference between
the amount charged by the provider and the approved fee
established by the insurer
⩥ Medicare.
Answer: A federal program of health insurance for persons 65
years of age and older by Part A (hospitalization) or Part B
(routine medical office visits)
⩥ Tricare.
Answer: U.S. government health insurance plan for all military
personnel
⩥ CHAMPVA.
Answer: covers surviving spouses and dependent children of
veterans who died as a result of service-related disabilities
,⩥ Medicaid.
Answer: provides health insurance to the medically indigent
population through a cost-sharing program between federal and
state governments for those who meet specific eligibility criteria
⩥ Managed Care.
Answer: is an umbrella term for plans that provide health care in
return for preset scheduled payments and coordinated care
through a defined network of providers and hospitals
⩥ CMS-1500 form.
Answer: Standard insurance form used by all government and
most commercial insurance payers.
- 33 blocks
- divided into three section
⩥ CMS-1500 Section 1.
Answer: Carrier Block: contains the address of the insurance
carrier and is located at the top of the form
⩥ CMS-1500 Section 2.
, Answer: Patient/insured section: contains information about the
patient or insured; includes boxes 1-13
⩥ CMS-1500 Section 3.
Answer: Physician/Supplier Section: contains information about
the physician or supplier: boxes 14-33
⩥ Supine Position.
Answer:
⩥ Dorsal Recumbent Position.
Answer:
⩥ Sims' Position.
Answer:
⩥ Knee-elbow position.
Answer:
⩥ Fowler's Position.
Answer:
