©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
CPB PRACTICE EXAM B Questions And
Answers 100% Pass.
What is the term for the total amount of covered medical expenses a policyholder must pay each
year out-of-pocket before the health insurance company begins to pay any benefits?
A. Copayment
B. Deductible
C. Secondary Payment
D. Coinsurance - answer✔B. Deductible
Which type of insurance covers physicians and other healthcare professionals for liability as to
claims arising
from patient treatment?
A. Business liability
B. Bonding
C. Medical malpractice
D. Workers' compensation - answer✔C. Medical malpractice
Which of the following does NOT fall under group policy insurance?
I. The premium is paid for by the
employee. II. The premium is paid for (or partially paid for) by an employer. III. The employer
selects the
plan(s) to offer to employees. IV. Physical exams and medical history questionnaires are a
mandatory
part of the application process. V. V. Employee can make changes to the policy. VI. The
employee's
, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
spouse and children are not eligible for coverage.
A. III, IV, V
B. II - VI
C. II, IV, V
D. I, IV, V, VI - answer✔D. I, IV, V, VI
Dr. Wallace is in a capitation contract with Belleview Managed Care Health Plan. He received
$25,000 from the health plan to provide services for the 175 enrollees on the
health plan. The services provided by Dr. Wallace to the enrollees cost $23,000. Based on the
information, what must be done?
A. Dr. Wallace can keep the $2,000 profit under the terms of the capitated plan.
B. Dr. Wallace experienced a loss under the capitated plan and will need to pay $2,000 to the
health
plan.
C. Dr. Wallace will need to payout the $2,000 to the 175 enrollees.
D. Dr. Wallace is required to put the $2,000 in a mutual fund. - answer✔A. Dr. Wallace can keep
the $2,000 profit under the terms of the capitated plan.
What is the deadline for filing a Medicare claim?
A. One year from the date of service
B. 30 days from the date of service
C. 90 days from the date of service
D. Two years from the date of service - answer✔A. One year from the date of service
What organization is responsible in evaluating the medical necessity, appropriateness, and
efficiency of
the use of healthcare services and procedures?
10/21/2024 9:24 PM
CPB PRACTICE EXAM B Questions And
Answers 100% Pass.
What is the term for the total amount of covered medical expenses a policyholder must pay each
year out-of-pocket before the health insurance company begins to pay any benefits?
A. Copayment
B. Deductible
C. Secondary Payment
D. Coinsurance - answer✔B. Deductible
Which type of insurance covers physicians and other healthcare professionals for liability as to
claims arising
from patient treatment?
A. Business liability
B. Bonding
C. Medical malpractice
D. Workers' compensation - answer✔C. Medical malpractice
Which of the following does NOT fall under group policy insurance?
I. The premium is paid for by the
employee. II. The premium is paid for (or partially paid for) by an employer. III. The employer
selects the
plan(s) to offer to employees. IV. Physical exams and medical history questionnaires are a
mandatory
part of the application process. V. V. Employee can make changes to the policy. VI. The
employee's
, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
spouse and children are not eligible for coverage.
A. III, IV, V
B. II - VI
C. II, IV, V
D. I, IV, V, VI - answer✔D. I, IV, V, VI
Dr. Wallace is in a capitation contract with Belleview Managed Care Health Plan. He received
$25,000 from the health plan to provide services for the 175 enrollees on the
health plan. The services provided by Dr. Wallace to the enrollees cost $23,000. Based on the
information, what must be done?
A. Dr. Wallace can keep the $2,000 profit under the terms of the capitated plan.
B. Dr. Wallace experienced a loss under the capitated plan and will need to pay $2,000 to the
health
plan.
C. Dr. Wallace will need to payout the $2,000 to the 175 enrollees.
D. Dr. Wallace is required to put the $2,000 in a mutual fund. - answer✔A. Dr. Wallace can keep
the $2,000 profit under the terms of the capitated plan.
What is the deadline for filing a Medicare claim?
A. One year from the date of service
B. 30 days from the date of service
C. 90 days from the date of service
D. Two years from the date of service - answer✔A. One year from the date of service
What organization is responsible in evaluating the medical necessity, appropriateness, and
efficiency of
the use of healthcare services and procedures?
