Test Bank for
Comprehensive Health
Insurance: Billing, Coding,
TE
and Reimbursement 3rd
S
edition By Deborah Vines,
TS
Ann Braceland
(All
O
LU
Chapters 1-17, 100% Original
Verified, A+ Grade)
TI
O
N
, Table of Content
SECTION I: A CAREER IN HEALTH CARE
Introduction to Professional Billing and Coding Careers
SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND
CARRIER
Understanding Managed Care: Insurance Plans
TE
Understanding Managed Care: Medical Contracts and Ethics
Introduction to the Health Insurance Portability and Accountability Act (HIPAA)
SECTION III: MEDICAL CODING
S
ICD-10-CM Medical Coding
Introduction to CPT and Place of Service Coding
TS
Coding Procedures and Services
HCPCS and Coding Compliance
Auditing
O
SECTION IV: MEDICAL CLAIMS
Physician Medical Billing
LU
Hospital Medical Billing
SECTION V: GOVERNMENT MEDICAL BILLING
Medicare Medical Billing
TI
Medicaid Medical Billing
TRICARE Medical Billing
O
SECTION VI: ACCOUNTS RECEIVABLE
Explanation of Benefits and Payment Adjudication
N
Refunds, Follow-Up, and Appeals
SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM
Workers’ Compensation
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Comprehensive Health Insurance, 3e (Vines)
Chapter 1 In tr od u ct i on to Professional Billing and Coding Careers
1.1 Multiple Choice Questions
1) The percentage of all healthcare providers who are physicians and nurses is:
A) 25%.
B) 40%.
TE
C) 50%.
D) 60%.
Answer: B
2) The percentage of all healthcare providers who are allied health professionals is:
A) 25%.
S
B) 40%.
C) 50%.
D) 60%.
TS
Answer: D
3) The increased demand for medical billers, medical office assistants, and medical coders can be
attributed to:
A) the growth of managed care.
B) physician practices' having more responsibility for filing claims.
O
C) the need for additional staff to file claims and work to obtain timely payment.
D) all of the above.
Answer: D
LU
4) A payment poster would most likely work in which facility?
A) a private practice.
B) a small-group practice.
C) a large-group practice.
D) all of the above.
TI
Answer: C
5) Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth of a
physician's practice would be based on:
O
A) advertising and referrals.
B) managed care contracts.
C) consultations.
D) hospital affiliations.
N
Answer: A
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6) Prior to the enactment of the Health Maintenance Organization Act of 1973, a solo practice
included all of the following staff members EXCEPT:
A) physician.
B) nurse.
C) certified medical biller.
D) receptionist.
Answer: C
TE
7) Managed care is a system in which physicians contract to participate in a health insurance
network and healthcare delivery is:
A) at the discretion of the physician.
B) provided only by in-network physicians.
C) based on the patient's ability to pay.
D) monitored to control costs.
S
Answer: D
8) Which facility would most likely employ a refund specialist?
TS
A) solo practice.
B) hospital.
C) large-group practice.
D) multi-specialty clinic.
Answer: B
O
9) It is common for small-group practices to outsource:
A) billing and accounts receivable.
B) insurance coverage verifications.
LU
C) appointment scheduling and patient reminders.
D) medical records management.
Answer: A
10) A practice with three physicians would generally be categorized as a:
A) solo practice.
TI
B) private practice.
C) small-group practice.
D) large-group practice.
Answer: C
O
11) A practice with 10 or more physicians would generally be categorized as a:
A) solo practice.
B) private practice.
N
C) small-group practice.
D) large-group practice.
Answer: D
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Comprehensive Health
Insurance: Billing, Coding,
TE
and Reimbursement 3rd
S
edition By Deborah Vines,
TS
Ann Braceland
(All
O
LU
Chapters 1-17, 100% Original
Verified, A+ Grade)
TI
O
N
, Table of Content
SECTION I: A CAREER IN HEALTH CARE
Introduction to Professional Billing and Coding Careers
SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND
CARRIER
Understanding Managed Care: Insurance Plans
TE
Understanding Managed Care: Medical Contracts and Ethics
Introduction to the Health Insurance Portability and Accountability Act (HIPAA)
SECTION III: MEDICAL CODING
S
ICD-10-CM Medical Coding
Introduction to CPT and Place of Service Coding
TS
Coding Procedures and Services
HCPCS and Coding Compliance
Auditing
O
SECTION IV: MEDICAL CLAIMS
Physician Medical Billing
LU
Hospital Medical Billing
SECTION V: GOVERNMENT MEDICAL BILLING
Medicare Medical Billing
TI
Medicaid Medical Billing
TRICARE Medical Billing
O
SECTION VI: ACCOUNTS RECEIVABLE
Explanation of Benefits and Payment Adjudication
N
Refunds, Follow-Up, and Appeals
SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM
Workers’ Compensation
, kjhgfds
Comprehensive Health Insurance, 3e (Vines)
Chapter 1 In tr od u ct i on to Professional Billing and Coding Careers
1.1 Multiple Choice Questions
1) The percentage of all healthcare providers who are physicians and nurses is:
A) 25%.
B) 40%.
TE
C) 50%.
D) 60%.
Answer: B
2) The percentage of all healthcare providers who are allied health professionals is:
A) 25%.
S
B) 40%.
C) 50%.
D) 60%.
TS
Answer: D
3) The increased demand for medical billers, medical office assistants, and medical coders can be
attributed to:
A) the growth of managed care.
B) physician practices' having more responsibility for filing claims.
O
C) the need for additional staff to file claims and work to obtain timely payment.
D) all of the above.
Answer: D
LU
4) A payment poster would most likely work in which facility?
A) a private practice.
B) a small-group practice.
C) a large-group practice.
D) all of the above.
TI
Answer: C
5) Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth of a
physician's practice would be based on:
O
A) advertising and referrals.
B) managed care contracts.
C) consultations.
D) hospital affiliations.
N
Answer: A
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, kjhgfds
6) Prior to the enactment of the Health Maintenance Organization Act of 1973, a solo practice
included all of the following staff members EXCEPT:
A) physician.
B) nurse.
C) certified medical biller.
D) receptionist.
Answer: C
TE
7) Managed care is a system in which physicians contract to participate in a health insurance
network and healthcare delivery is:
A) at the discretion of the physician.
B) provided only by in-network physicians.
C) based on the patient's ability to pay.
D) monitored to control costs.
S
Answer: D
8) Which facility would most likely employ a refund specialist?
TS
A) solo practice.
B) hospital.
C) large-group practice.
D) multi-specialty clinic.
Answer: B
O
9) It is common for small-group practices to outsource:
A) billing and accounts receivable.
B) insurance coverage verifications.
LU
C) appointment scheduling and patient reminders.
D) medical records management.
Answer: A
10) A practice with three physicians would generally be categorized as a:
A) solo practice.
TI
B) private practice.
C) small-group practice.
D) large-group practice.
Answer: C
O
11) A practice with 10 or more physicians would generally be categorized as a:
A) solo practice.
B) private practice.
N
C) small-group practice.
D) large-group practice.
Answer: D
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