AAPC CPB - Chapter 12 Review Exam Question with correct Answers

The term for the set payment that the member pays to the healthcare provider on the day of service is the: a. office visit fee. b. co-insurance. c. copay. d. co-signer. - Answer- c. copay. Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance coverage as the: a. Member b. Group c. Subscriber d. Payer - Answer- c. Subscriber What information can be found on the Blue Cross/Blue Shield insurance identification card? I. Type of plan II. Subscriber's address and phone number III. ID number IV. Group number V. Name of primary care provider VI. Phone number for Member Services/Benefits questions VII. Mailing address of BC/BS office a. II, V, VII b. I, III, IV, VI c. V, VI, VII d. I, III, IV, VI, VII - Answer- d. I, III, IV, VI, VII The Blue Cross/Blue Shield member's insurance card will list which of the following: a. provider's name. b. type of insurance. c. type of plan. d. both b & c. - Answer- d. both b & c. The document reporting the benefits applied to a Blue Cross/Blue Shield claim is the: a. Explanation of Payment (EOP). b. Explanation of Benefits (EOB). c. Explanation of Coverage (EOC). d. None of the above. - Answer- b. Explanation of Benefits (EOB). Blue Cross and Blue Shield is the: a. oldest and smallest family of health benefits companies in the United States. b. newest and largest family of health benefits companies in the United States. c. oldest and largest family of health benefits companies in the United States. d. only health insurance company promoting preferred provider organizations. - Answer- c. oldest and largest family of health benefits companies in the United States. Blue Cross/Blue Shield offers which type of Medicare plan? a. Medicare Plus b. Medicare Advantage c. Medicare Part G d. Medicare Add-on - Answer- b. Medicare Advantage Developing a strong relationship with the insurance Provider Representative will result in: