AAPC CPB - Chapter 12 Review 100%
Accurate!!
The term for the set payment that the member pays to the healthcare provider on the
day of service is the:
a. office visit fee.
b. co-insurance.
c. copay.
d. co-signer. - ANSWERSc. copay.
Response Feedback:
A copayment or copay is the set amount the insured member pays the healthcare
provider on the day of service.
Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare
insurance coverage as the:
a. Member
b. Group
c. Subscriber
d. Payer - ANSWERSc. Subscriber
Response Feedback:
The subscriber is the person who pays for the health insurance or whose employment
makes him or her eligible for group health insurance.
What information can be found on the Blue Cross/Blue Shield insurance identification
card?
I. Type of plan
II. Subscriber's address and phone number
III. ID number
IV. Group number
V. Name of primary care provider
VI. Phone number for Member Services/Benefits questions
VII. Mailing address of BC/BS office
a. II, V, VII
b. I, III, IV, VI
c. V, VI, VII
d. I, III, IV, VI, VII - ANSWERSd. I, III, IV, VI, VII
, Response Feedback:
The type of plan, ID number, group number, phone numbers and mailing address of the
BC/BS office for submission of paper claims are some of the information found on the
insurance ID card. Additional information such as prescription, co-pay and deductible
amounts can also be referenced on the card.
The Blue Cross/Blue Shield member's insurance card will list which of the following:
a. provider's name.
b. type of insurance.
c. type of plan.
d. both b & c. - ANSWERSd. both b & c.
The document reporting the benefits applied to a Blue Cross/Blue Shield claim is the:
a. Explanation of Payment (EOP).
b. Explanation of Benefits (EOB).
c. Explanation of Coverage (EOC).
d. None of the above. - ANSWERSb. Explanation of Benefits (EOB).
Response Feedback:
Blue Cross/Blue Shield sends an Explanation of Benefits (EOB), to their covered
members after they or other family members receive healthcare services to explain the
status of a claim.
Blue Cross and Blue Shield is the:
a. oldest and smallest family of health benefits companies in the United States.
b. newest and largest family of health benefits companies in the United States.
c. oldest and largest family of health benefits companies in the United States.
d. only health insurance company promoting preferred provider organizations. -
ANSWERSc. oldest and largest family of health benefits companies in the United
States.
Response Feedback:
Blue Cross and Blue Shield companies is the nation's oldest and largest family of health
benefits companies. Nationwide, Blue Cross and Blue Shield has more than 96 percent
of hospitals and 95 percent of professional providers contracted with them.
Blue Cross/Blue Shield offers which type of Medicare plan?
a. Medicare Plus
Accurate!!
The term for the set payment that the member pays to the healthcare provider on the
day of service is the:
a. office visit fee.
b. co-insurance.
c. copay.
d. co-signer. - ANSWERSc. copay.
Response Feedback:
A copayment or copay is the set amount the insured member pays the healthcare
provider on the day of service.
Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare
insurance coverage as the:
a. Member
b. Group
c. Subscriber
d. Payer - ANSWERSc. Subscriber
Response Feedback:
The subscriber is the person who pays for the health insurance or whose employment
makes him or her eligible for group health insurance.
What information can be found on the Blue Cross/Blue Shield insurance identification
card?
I. Type of plan
II. Subscriber's address and phone number
III. ID number
IV. Group number
V. Name of primary care provider
VI. Phone number for Member Services/Benefits questions
VII. Mailing address of BC/BS office
a. II, V, VII
b. I, III, IV, VI
c. V, VI, VII
d. I, III, IV, VI, VII - ANSWERSd. I, III, IV, VI, VII
, Response Feedback:
The type of plan, ID number, group number, phone numbers and mailing address of the
BC/BS office for submission of paper claims are some of the information found on the
insurance ID card. Additional information such as prescription, co-pay and deductible
amounts can also be referenced on the card.
The Blue Cross/Blue Shield member's insurance card will list which of the following:
a. provider's name.
b. type of insurance.
c. type of plan.
d. both b & c. - ANSWERSd. both b & c.
The document reporting the benefits applied to a Blue Cross/Blue Shield claim is the:
a. Explanation of Payment (EOP).
b. Explanation of Benefits (EOB).
c. Explanation of Coverage (EOC).
d. None of the above. - ANSWERSb. Explanation of Benefits (EOB).
Response Feedback:
Blue Cross/Blue Shield sends an Explanation of Benefits (EOB), to their covered
members after they or other family members receive healthcare services to explain the
status of a claim.
Blue Cross and Blue Shield is the:
a. oldest and smallest family of health benefits companies in the United States.
b. newest and largest family of health benefits companies in the United States.
c. oldest and largest family of health benefits companies in the United States.
d. only health insurance company promoting preferred provider organizations. -
ANSWERSc. oldest and largest family of health benefits companies in the United
States.
Response Feedback:
Blue Cross and Blue Shield companies is the nation's oldest and largest family of health
benefits companies. Nationwide, Blue Cross and Blue Shield has more than 96 percent
of hospitals and 95 percent of professional providers contracted with them.
Blue Cross/Blue Shield offers which type of Medicare plan?
a. Medicare Plus
