Questions and Answers (Latest Update
2026)
What are two ways of verifying eligibility status? -
correct answer ✅Using the social security number or member ID.
What is Preauthorization? -
correct answer ✅A pre-approval by a health insurer or plan that a
health care service, treatment plan, prescription drug or durable
medical equipment is medically necessary .
What should a medical assistant obtain before the preauthorization
process? -
correct answer ✅A Medical Assistant must obtain a description of
the service, the pt.'s diagnosis, any relevant information to justify
the need for service, and the proposed date of service. In addition,
the medical assistant will have to provide the pt.'s demographic and
insurance information as well as the National Provider Identifier
(NPI) numbers and contact information
What is a pcp? -
correct answer ✅Primary Care Physician. A health care provider
that provides most of the pt. health care and refers the pt. to
receive the proper care they need from specific specialist.
, MA (Insurance/Billing and coding) Exam
Questions and Answers (Latest Update
2026)
Why is a PCP referred to as a Gatekeeper? -
correct answer ✅The gatekeeper must approve medical test and
treatment and even refer you for additional medical care.
Why is authorization for a specialist not required? -
correct answer ✅Authorization for a specialist is not required
because this is called self-referral. This alerts the staff that no
additional paperwork is required.
The referral comes from the primary physician.
Why can't a practice function without cash flow? -
correct answer ✅A practice cannot function without cash flow
because for a business to be successful, it must always have
sufficient cash. It needs cash to pay its expenses, equipment,
employees.
List 3 functions of an Accountant in a Medical practice? -
correct answer ✅One function of an accountant in a medical office
is reporting financial transactions. Second function is entering
income when payment is received for services. The last function is
income being entered at the time of sale, even if payment has not
been paid yet. They also handle to doctors taxes.