Coding and Reimbursement Final
Exam Questions and Answers
A benefit paid to wartime veterans with limited income who are no longer able to work
is: - ANS-Veterans Disability Pension Benefits
A centralized billing office (CBO) typically contracts with a physician's office to perform
which of the following functions? - ANS-Handling claims and/or accounts receivable
A company that receives claims from providers, audits them, and forwards them on to
insurance carriers is a(n): - ANS-clearinghouse
A contract with which of the following payment terms can result in an increased financial
risk to the provider? - ANS-capitation
A group of physicians with different specialties may practice together at one outpatient
facility known as a: - ANS-multi-specialty clinic
A managed care contract is considered a legal document between the: - ANS-patient
and insurer
During the patient's care, all procedures and tests are documented on the: - ANS-
encounter form
Group insurance is issued to an employer to provide coverage for: - ANS-employees
and all their dependents.
HCPCS Level II codes are updated annually by the: - ANS-Centers for Medicare and
Medicaid Services (CMS)
HCPCS is the acronym for the: - ANS-Healthcare Common Procedure Coding System
HCPCS modifiers consist of: - ANS-two letters or one letter and one number
HIPAA requires that diagnoses and services be reported in a standard, consistent
manner, this is accomplised by using uniform: - ANS-code sets
If a patient has more than one insurance plan, the determination of how much will be
paid by each is known as: - ANS-coordination of benefits
, If an employee feels that his or her work environment is unsafe, he or she may file a
complaint with the: - ANS-Occupational Safety and Health Administration
If needed information is missing from a claim when it is submitted to an insurance
carrier, it is referred to as a(n): - ANS-dirty claim
In 2011, the new health care reform law required insurers to offer dependent coverage
for adult children up to age____ so they could be included on their parents' coverage: -
ANS-26
In a managed care organization (MCO), a primary care physician (PCP) is any of the
following EXCEPT: - ANS-dermatologist
In coding late (residual) effects, the coder should: - ANS-code first the late effect
followed by the code for its cause
In order to receive the Certified Professional Coder (CPC) certification, you must: -
ANS-have 2 years of work experience and pass the certification exam
Medicaid is paid for by: - ANS-the federal and state government
Medical benefits for an injured worker begin: - ANS-immediately and have no specific
time limit
Most hospitals today are owned by a: - ANS-corporation
OSHA stands for the: - ANS-Occupational Safety and Health Administration
Once a Medicare beneficiary signs the ______, he or she is legally responsible for the
charges if Medicare denies payment for the service as "not medically necessary" - ANS-
ABN
Medicaid is health insurance coverage for: - ANS-low-income individuals
Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth
of a physician's practice would be based on: - ANS-advertising and referrals
Temporary income benefits end: - ANS-once the employee is able to return to work.
Income benefits
Terms that refer to fees in an insurance contract included all of the following EXCEPT: -
ANS-ordinary
The Affordable Care Act represents the most significant overhaul of the U.S. healthcare
system since: - ANS-Both A and B
Exam Questions and Answers
A benefit paid to wartime veterans with limited income who are no longer able to work
is: - ANS-Veterans Disability Pension Benefits
A centralized billing office (CBO) typically contracts with a physician's office to perform
which of the following functions? - ANS-Handling claims and/or accounts receivable
A company that receives claims from providers, audits them, and forwards them on to
insurance carriers is a(n): - ANS-clearinghouse
A contract with which of the following payment terms can result in an increased financial
risk to the provider? - ANS-capitation
A group of physicians with different specialties may practice together at one outpatient
facility known as a: - ANS-multi-specialty clinic
A managed care contract is considered a legal document between the: - ANS-patient
and insurer
During the patient's care, all procedures and tests are documented on the: - ANS-
encounter form
Group insurance is issued to an employer to provide coverage for: - ANS-employees
and all their dependents.
HCPCS Level II codes are updated annually by the: - ANS-Centers for Medicare and
Medicaid Services (CMS)
HCPCS is the acronym for the: - ANS-Healthcare Common Procedure Coding System
HCPCS modifiers consist of: - ANS-two letters or one letter and one number
HIPAA requires that diagnoses and services be reported in a standard, consistent
manner, this is accomplised by using uniform: - ANS-code sets
If a patient has more than one insurance plan, the determination of how much will be
paid by each is known as: - ANS-coordination of benefits
, If an employee feels that his or her work environment is unsafe, he or she may file a
complaint with the: - ANS-Occupational Safety and Health Administration
If needed information is missing from a claim when it is submitted to an insurance
carrier, it is referred to as a(n): - ANS-dirty claim
In 2011, the new health care reform law required insurers to offer dependent coverage
for adult children up to age____ so they could be included on their parents' coverage: -
ANS-26
In a managed care organization (MCO), a primary care physician (PCP) is any of the
following EXCEPT: - ANS-dermatologist
In coding late (residual) effects, the coder should: - ANS-code first the late effect
followed by the code for its cause
In order to receive the Certified Professional Coder (CPC) certification, you must: -
ANS-have 2 years of work experience and pass the certification exam
Medicaid is paid for by: - ANS-the federal and state government
Medical benefits for an injured worker begin: - ANS-immediately and have no specific
time limit
Most hospitals today are owned by a: - ANS-corporation
OSHA stands for the: - ANS-Occupational Safety and Health Administration
Once a Medicare beneficiary signs the ______, he or she is legally responsible for the
charges if Medicare denies payment for the service as "not medically necessary" - ANS-
ABN
Medicaid is health insurance coverage for: - ANS-low-income individuals
Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth
of a physician's practice would be based on: - ANS-advertising and referrals
Temporary income benefits end: - ANS-once the employee is able to return to work.
Income benefits
Terms that refer to fees in an insurance contract included all of the following EXCEPT: -
ANS-ordinary
The Affordable Care Act represents the most significant overhaul of the U.S. healthcare
system since: - ANS-Both A and B
