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AMCA Medical Coding/billing Certification
Exam Questions and Answers 100% Pass
What type of insurance allows treatment virtually anywhere with a high deductible that policy
holders are willing to pay? - ANS PPO
Veterans with service related disabilities are eligible for case under which program? -
ANS CHAMPVA
__________ is usually sponsored and partially paid by an employer - ANS Group Health
Insurance
__________ are used to report encounters for circumstances other than a disease or injury in
the ICD-10-CM - ANS E codes
The abbreviation PMPM stands for - ANS Per Member Per Month
Schedule of benefits means - ANS medical service covered under the insured's policy
Medicare is funded by - ANS Federal funds
physicians establish a list of their usual fees for: - ANS the procedures and services they
frequently perform
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, ©FYNDLAY 2025 ALL RIGHTS RESERVED
the insurance carrier is allowed to use nay method to determine the amount for a service, also
known as the: - ANS allowed amount
Which of the following statements is true under the doctrine of respondeat superior? -
ANS The physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following? - ANS Health Insurance Portability and
Accountability Act
Information given by a patient to medical personnel that cannot be disclosed without consent
constitutes: - ANS privileged communication
Why is a super bill/encounter form an important document in the office? - ANS it's ensures
the correct patient data information and procedures
Which of the following facilities does NOT use CMS-1500 forms? - ANS Nursing home
Physicians usually submit claims for patients and receive payments directly for the payers. The
policy holder authorizes this by signing and dating a: - ANS Assignment of benefits
Under the HIPAA Privacy Rule, providers do not need specific authorization in order to release a
patients PHI for TPO purposes. What does TPO stand for? - ANS Treatment, Payment, and
Health Care operations
If both parents cover dependents on their plan, the child's primary insurance is usually
determined by the birthday rule. What is meant by the birthday rule? - ANS The parent
whose birthday is earlier in the calendar year is the primary
There are three participants in the medical insurance relationship: the first party, the second
party and the third party. Who is referred to as the second party? - ANS physician
©FYNDLAY 2
AMCA Medical Coding/billing Certification
Exam Questions and Answers 100% Pass
What type of insurance allows treatment virtually anywhere with a high deductible that policy
holders are willing to pay? - ANS PPO
Veterans with service related disabilities are eligible for case under which program? -
ANS CHAMPVA
__________ is usually sponsored and partially paid by an employer - ANS Group Health
Insurance
__________ are used to report encounters for circumstances other than a disease or injury in
the ICD-10-CM - ANS E codes
The abbreviation PMPM stands for - ANS Per Member Per Month
Schedule of benefits means - ANS medical service covered under the insured's policy
Medicare is funded by - ANS Federal funds
physicians establish a list of their usual fees for: - ANS the procedures and services they
frequently perform
©FYNDLAY 1
, ©FYNDLAY 2025 ALL RIGHTS RESERVED
the insurance carrier is allowed to use nay method to determine the amount for a service, also
known as the: - ANS allowed amount
Which of the following statements is true under the doctrine of respondeat superior? -
ANS The physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following? - ANS Health Insurance Portability and
Accountability Act
Information given by a patient to medical personnel that cannot be disclosed without consent
constitutes: - ANS privileged communication
Why is a super bill/encounter form an important document in the office? - ANS it's ensures
the correct patient data information and procedures
Which of the following facilities does NOT use CMS-1500 forms? - ANS Nursing home
Physicians usually submit claims for patients and receive payments directly for the payers. The
policy holder authorizes this by signing and dating a: - ANS Assignment of benefits
Under the HIPAA Privacy Rule, providers do not need specific authorization in order to release a
patients PHI for TPO purposes. What does TPO stand for? - ANS Treatment, Payment, and
Health Care operations
If both parents cover dependents on their plan, the child's primary insurance is usually
determined by the birthday rule. What is meant by the birthday rule? - ANS The parent
whose birthday is earlier in the calendar year is the primary
There are three participants in the medical insurance relationship: the first party, the second
party and the third party. Who is referred to as the second party? - ANS physician
©FYNDLAY 2
