Fordney's Medical Insurance & Billing
Test Bank – 17th Edition (Chapters 1-20)
Questions and Answers 2026/2027 Sure
Pass
# Term Definition
1 HMO Comprehensive health care
financing and delivery
organization that provides a wide
range of health care services to
enrollees within a geographic
area, with an emphasis on
preventive medicine through a
panel of providers
2 POS Managed care plan in which
members are given a choice as
to how to receive services,
whether through an HMO, PPO,
or fee-for-service plan
3 EPO Health benefit program in which
enrollees receive the highest level
of benefits when they obtain
services from a preferred
provider
4 NPI National Provider Identifier
1
,5 IPA Type of HMO in which a
program administrator contracts
with a number of physicians
who agree to give treatment to
subscribers in their own offices
for a fixed capitation payment
per month
6 It is not necessary to true
retain logs of
telephone
conversations with
insurance carriers
regarding nonpayment
of claims?
7 Patients who do not false
have insurance should
pay cash and should
not be sent monthly
statements
8 After filing an true
insurance claim,
payment from the
third-party payer
should be received in 2
to 8 weeks
accompanied by an
explanation of benefits
document ?
9 Electronic funds true
transfer allows
automatic deposit of
funds from the third-
party payer into the
provider’s bank
account for payment
of insurance claims
2
,MEDICAL BILLING
# Term Definition
10 A participating false
provider should
attempt to collect the
difference between
the charged amount
and the Medicare
allowed amount from
the patient
11 An emancipated minor false
is a person older than
age 18 years who lives
independently and is
supported by his or
her parents
12 A specific amount of Deductible
money that must be
paid each year before
an insurance policy’s
benefits begin is
known as a/an
13 The spouse and children Dependents
of the policyholder are
called
14 An insurance a. Insuredb. Member c. Subscriber
policyholder is also
known as a/an
15 When a patient is Physician and the insurance
being treated for an company
industrial injury, the
contract is between
the
3
, MEDICAL BILLING
16 A health insurance Major medical insurance
policy designed to
offset heavy medical
expenses resulting
from catastrophic or
prolonged illness or
injury is known as
17 A person who is Emancipated minor
younger than age 18
years and who lives
independently, is self-
supporting, and
possesses decision-
making rights is known
as a/an
18 A questionnaire Patient registration form
designed to collect
demographic data
and essential facts
about medical
insurance coverage
for each patient
seen for
professional
services is called
a/an
4
Test Bank – 17th Edition (Chapters 1-20)
Questions and Answers 2026/2027 Sure
Pass
# Term Definition
1 HMO Comprehensive health care
financing and delivery
organization that provides a wide
range of health care services to
enrollees within a geographic
area, with an emphasis on
preventive medicine through a
panel of providers
2 POS Managed care plan in which
members are given a choice as
to how to receive services,
whether through an HMO, PPO,
or fee-for-service plan
3 EPO Health benefit program in which
enrollees receive the highest level
of benefits when they obtain
services from a preferred
provider
4 NPI National Provider Identifier
1
,5 IPA Type of HMO in which a
program administrator contracts
with a number of physicians
who agree to give treatment to
subscribers in their own offices
for a fixed capitation payment
per month
6 It is not necessary to true
retain logs of
telephone
conversations with
insurance carriers
regarding nonpayment
of claims?
7 Patients who do not false
have insurance should
pay cash and should
not be sent monthly
statements
8 After filing an true
insurance claim,
payment from the
third-party payer
should be received in 2
to 8 weeks
accompanied by an
explanation of benefits
document ?
9 Electronic funds true
transfer allows
automatic deposit of
funds from the third-
party payer into the
provider’s bank
account for payment
of insurance claims
2
,MEDICAL BILLING
# Term Definition
10 A participating false
provider should
attempt to collect the
difference between
the charged amount
and the Medicare
allowed amount from
the patient
11 An emancipated minor false
is a person older than
age 18 years who lives
independently and is
supported by his or
her parents
12 A specific amount of Deductible
money that must be
paid each year before
an insurance policy’s
benefits begin is
known as a/an
13 The spouse and children Dependents
of the policyholder are
called
14 An insurance a. Insuredb. Member c. Subscriber
policyholder is also
known as a/an
15 When a patient is Physician and the insurance
being treated for an company
industrial injury, the
contract is between
the
3
, MEDICAL BILLING
16 A health insurance Major medical insurance
policy designed to
offset heavy medical
expenses resulting
from catastrophic or
prolonged illness or
injury is known as
17 A person who is Emancipated minor
younger than age 18
years and who lives
independently, is self-
supporting, and
possesses decision-
making rights is known
as a/an
18 A questionnaire Patient registration form
designed to collect
demographic data
and essential facts
about medical
insurance coverage
for each patient
seen for
professional
services is called
a/an
4
