Comprehensive Health Insurance: Billing, Coding, and Reimbursement by Deborah Vines, Ann Braceland & Elizabeth Rollins | Complete Test Bank for Chapters 1–17

TEST BANK
Comprehensive Health Insurance: Billing, Coding, and Reimbursement |
3rd edition

By Deborah Vines, Ann Braceland, Elizabeth Rollins, Susan
Miller
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,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
Understanding Managed Care: Medical Contracts and Ethics
Introduction to the Health Insurance Portability and Accountability Act (HIPAA)
SECTION III: MEDICAL CODING
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ICD-10-CM Medical Coding
Introduction to CPT and Place of Service Coding
Coding Procedures and Services
HCPCS and Coding Compliance
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Auditing
SECTION IV: MEDICAL CLAIMS
Physician Medical Billing
Hospital Medical Billing
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SECTION V: GOVERNMENT MEDICAL BILLING
Medicare Medical Billing
Medicaid Medical Billing
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TRICARE Medical Billing
SECTION VI: ACCOUNTS RECEIVABLE
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Explanation of Benefits and Payment Adjudication
Refunds, Follow-Up, and Appeals
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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%.
C) 50%.
D) 60%.
Answer: B
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2) The percentage of all healthcare providers who are allied health professionals is:
A) 25%.
B) 40%.
C) 50%.
D) 60%.
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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.
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C) the need for additional staff to file claims and work to obtain timely payment.
D) all of the above.
Answer: D
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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.
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D) all of the above.
Answer: C
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5) Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth of a
physician's practice would be based on:
A) advertising and referrals.
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B) managed care contracts.
C) consultations.
D) hospital affiliations.
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

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.
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B) provided only by in-network physicians.
C) based on the patient's ability to pay.
D) monitored to control costs.
Answer: D

8) Which facility would most likely employ a refund specialist?
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A) solo practice.
B) hospital.
C) large-group practice.
D) multi-specialty clinic.
Answer: B
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9) It is common for small-group practices to outsource:
A) billing and accounts receivable.
B) insurance coverage verifications.
C) appointment scheduling and patient reminders.
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D) medical records management.
Answer: A
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10) A practice with three physicians would generally be categorized as a:
A) solo practice.
B) private practice.
C) small-group practice.
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D) large-group practice.
Answer: C
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11) A practice with 10 or more physicians would generally be categorized as a:
A) solo practice.
B) private practice.
C) small-group practice.
D) large-group practice.
Answer: D




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