Aitempt Score 75/75-100%
Oversl Grade Highest Attempt) 75 /75-100%
Queston1 1/1point
Inatich type o hslthcae payment method. coes the helthes plan overses bt the costsof
heshcare snd th outcomes o care?
Traditions etospective
Cose sse
Resource based relstive vlue scale
) Maraged care
Question2 1/1point
Inthe sccounting systemofthe phyician ffic, th sccount i categorzed s <.y How should the
insurance aalyst nerprt s category?
(&) The usrantorwi py th e i
The physican. imscl o herself,will pick up the balanceof th bil.
The crmpoyersl insured hslthare nsuranceplan will over the sccournt.
The patient il pay deductibes and noncavered charges
Question3 1/ 1point
Inutich type o heslthcae payment method doss the hesthcar plan ecompense proiders with s
fatefo each dy 2 covered member i hosptlized?
Traiions!
Episoco otcare
& perdiem
Fee forsenice
Questiond, 1/ 1point
Inthe US healh system which pyer hs the greatest nflucnce on payment methods?
Stte o Caforia
) Federalgovernment
Metticare Payment Adisary Commission
Universs coversge
Question's 1/ 1point
Inatich type o hesltheae payment method cocs the hesithear pian pa fo eachservice that s provder
renders?
Episode-of carerlmbersement.
Blockgrant
) Fee forsenicerimbursemert
bl payment
,Question 6 /1 point
‘Which govrrmental fraud nd sbuse ffort focused o recouping ot funds fo the Mecicare Program due
1o insceurats coding snd biling? S166 milon were recovere during the firt o yesrs o i cffort.
Hospial Payment Mositoring Program
016 Compiance rogram Guicance
) Operation Restore Tt
Medicare Itcgrity Program
Question? /1 point
Which ofthe folowing harscterstics i epresentative of commerca healtheare insurances?
Natonal federaton ffortyindependentlocallyoperate plans
Composed o geogrsphic plans nd the FEP
& For profitin the pivate sector
Account forshout one ourthof US heslthere cxpenditures
Questions, 1/1point
Whichof e following s the correct format or HCPCS Level | codes?
12308
1230
12004
1h234
oLt
Questions. 1/ 1point
The physician's offcesent 2 reques for paymert Al nsurance Company. The term used n the
heathcare industey for tisrequest for payment s o)
Alovance
Crarge
Slockgrant
& Caim
Question 10 1/1point
The gusrantor had i $2.000 3 coinsurance o vaious mecics i, P the hesitheare nsurance plicy
the heslthcare insurance plan v now sy 100 percens of remsining bils ith o cofnsurance being
‘Ssscsset o the puarantor, Whst type of rovisian o this cause i the oy represent?
Stoploss bentic:
Maimum out of pocket cost
Ctastrophic expense it
& Aot the sbove
Oversl Grade Highest Attempt) 75 /75-100%
Queston1 1/1point
Inatich type o hslthcae payment method. coes the helthes plan overses bt the costsof
heshcare snd th outcomes o care?
Traditions etospective
Cose sse
Resource based relstive vlue scale
) Maraged care
Question2 1/1point
Inthe sccounting systemofthe phyician ffic, th sccount i categorzed s <.y How should the
insurance aalyst nerprt s category?
(&) The usrantorwi py th e i
The physican. imscl o herself,will pick up the balanceof th bil.
The crmpoyersl insured hslthare nsuranceplan will over the sccournt.
The patient il pay deductibes and noncavered charges
Question3 1/ 1point
Inutich type o heslthcae payment method doss the hesthcar plan ecompense proiders with s
fatefo each dy 2 covered member i hosptlized?
Traiions!
Episoco otcare
& perdiem
Fee forsenice
Questiond, 1/ 1point
Inthe US healh system which pyer hs the greatest nflucnce on payment methods?
Stte o Caforia
) Federalgovernment
Metticare Payment Adisary Commission
Universs coversge
Question's 1/ 1point
Inatich type o hesltheae payment method cocs the hesithear pian pa fo eachservice that s provder
renders?
Episode-of carerlmbersement.
Blockgrant
) Fee forsenicerimbursemert
bl payment
,Question 6 /1 point
‘Which govrrmental fraud nd sbuse ffort focused o recouping ot funds fo the Mecicare Program due
1o insceurats coding snd biling? S166 milon were recovere during the firt o yesrs o i cffort.
Hospial Payment Mositoring Program
016 Compiance rogram Guicance
) Operation Restore Tt
Medicare Itcgrity Program
Question? /1 point
Which ofthe folowing harscterstics i epresentative of commerca healtheare insurances?
Natonal federaton ffortyindependentlocallyoperate plans
Composed o geogrsphic plans nd the FEP
& For profitin the pivate sector
Account forshout one ourthof US heslthere cxpenditures
Questions, 1/1point
Whichof e following s the correct format or HCPCS Level | codes?
12308
1230
12004
1h234
oLt
Questions. 1/ 1point
The physician's offcesent 2 reques for paymert Al nsurance Company. The term used n the
heathcare industey for tisrequest for payment s o)
Alovance
Crarge
Slockgrant
& Caim
Question 10 1/1point
The gusrantor had i $2.000 3 coinsurance o vaious mecics i, P the hesitheare nsurance plicy
the heslthcare insurance plan v now sy 100 percens of remsining bils ith o cofnsurance being
‘Ssscsset o the puarantor, Whst type of rovisian o this cause i the oy represent?
Stoploss bentic:
Maimum out of pocket cost
Ctastrophic expense it
& Aot the sbove
