AETNA Exam Review Questions with Verified
Correct Answers
ECR Program
Preauthorization vendors that do authorizations for some procedures. Gives preauthorization
for medical necessity, steers mms to preferred par providers and includes ambulatory surgery
centers due to expansion of the cardiac rhythm implantable program.
What is the turnaround time for making and keeping a commitment (health concierge
model)?
Finish all commitments within 3 - 5 business days. Some commitments may need more time.
In general, take care of all commitments within 10 business days
When do we cover paternity testing?
does not cover paternity testing to determine a child's father.
What is the definition of open enrollment?
a period during which one may freely enroll in or change one's selection of a health insurance
plan or other benefit program that is ordinarily subject to restrictions.
Are Aetna members charged for the release of X-Rays from radiology and pathology
labs
Aetna members may not be charged for copies of X-rays nor may deposits be required for the
release of X-ray filmsAnswer: Yes, the ambulance provider is entitled to be paid when the
ambulance service provides emergency treatment at the scene.
What information should be emailed to MPPS (Medical Policy & Program Support) for
a gender edit request
, Member's identification (ID) number
Aetna Student Health ID (when it applies)
Member's name
Patients' transgender identification (female-to-male transgender, gender fluid, male-to-female
transgender or nonbinary)
What services are included as part of a routine physical exam?
Associated laboratory and radiology services done with this exam
Check of the body for likely signs or symptoms of a medical condition
Discussion of the exam results with the patient or, in the case of a dependent child, the parent
or guardian
Eye exams if done in the Primary Care Physician (PCP) office
Materials for and the administration of immunizations of infectious disease
Review of written record of the patient's medical history followed by an examination of the
symptoms
e.Policies
an application that offers access to coverage policy and procedural content for the different
departments within the Aetna Services Organization
HSA
This is an account added on to a medical plan that the member can take with them when they
switch jobs and they can continue to use the money from the account for qualified medical
expenses
1. All the following provider types can be selected as a PCP EXCEPT:
a. Internist
Correct Answers
ECR Program
Preauthorization vendors that do authorizations for some procedures. Gives preauthorization
for medical necessity, steers mms to preferred par providers and includes ambulatory surgery
centers due to expansion of the cardiac rhythm implantable program.
What is the turnaround time for making and keeping a commitment (health concierge
model)?
Finish all commitments within 3 - 5 business days. Some commitments may need more time.
In general, take care of all commitments within 10 business days
When do we cover paternity testing?
does not cover paternity testing to determine a child's father.
What is the definition of open enrollment?
a period during which one may freely enroll in or change one's selection of a health insurance
plan or other benefit program that is ordinarily subject to restrictions.
Are Aetna members charged for the release of X-Rays from radiology and pathology
labs
Aetna members may not be charged for copies of X-rays nor may deposits be required for the
release of X-ray filmsAnswer: Yes, the ambulance provider is entitled to be paid when the
ambulance service provides emergency treatment at the scene.
What information should be emailed to MPPS (Medical Policy & Program Support) for
a gender edit request
, Member's identification (ID) number
Aetna Student Health ID (when it applies)
Member's name
Patients' transgender identification (female-to-male transgender, gender fluid, male-to-female
transgender or nonbinary)
What services are included as part of a routine physical exam?
Associated laboratory and radiology services done with this exam
Check of the body for likely signs or symptoms of a medical condition
Discussion of the exam results with the patient or, in the case of a dependent child, the parent
or guardian
Eye exams if done in the Primary Care Physician (PCP) office
Materials for and the administration of immunizations of infectious disease
Review of written record of the patient's medical history followed by an examination of the
symptoms
e.Policies
an application that offers access to coverage policy and procedural content for the different
departments within the Aetna Services Organization
HSA
This is an account added on to a medical plan that the member can take with them when they
switch jobs and they can continue to use the money from the account for qualified medical
expenses
1. All the following provider types can be selected as a PCP EXCEPT:
a. Internist
