Introduction to Health Insurance/ Managed health
care Exam UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Which was the first commercial insurance company in the United States to provide private
health care coverage for injuries not result in death? - CORRECT ANSWER Franklin
health Assurance Company
Which replaced the 1908 workers compensation legislation and provided civilian employees
of the federal government with medical care, survivors benefits and compensation for lost
wages? - CORRECT ANSWER Federal Employees Compensation Act
The first Blue Cross policy was introduced by? - CORRECT ANSWER Baylor
University in Dallas Texas
The Blue Shield concept grew out of the lumber and mining camps of the _______ region at
the turn of the century. - CORRECT ANSWER Pacific Northwest
Health care coverage offered by ________ its called group health insurance. - CORRECT
ANSWER Employees
The Hill-Burton Act provided federal grants from modernizing hospitals that had become
obsolete because of lack of capital investment during the Great Depression and World War
and WWII (1929 to 1945). in return for federal funds, _______________. - CORRECT
ANSWER facilities were required to provide service free or at reduced rates to patients
unable to pay for care.
Third-party administrators (TPA's) administer health care plans and process claims, serving
as a _________________. - CORRECT ANSWER System of checks and balance for
labor and management.a
Major medical insurance provides coverage for_______________ illness and injuries,
incorporating large deductibles and lifetime maximum amount. - CORRECT
ANSWER catastrophic or prolonged.
, The government health plan that provides health care services to Americans over the age of
65 is called_____________________. - CORRECT ANSWER Medicare
The percentage of cost a patient shares with the health plan ( e.g., plan pays 80% of costs and
patient pays 20%) is called __________. - CORRECT ANSWER coinsurance.
The Tax Equity in Fiscal Responsibility Act of 1982 (TEFRA) enacted the _____________
prospective payment system (PPS). - CORRECT ANSWER diagnosis- related groups
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all
laboratories testing to ensure accuracy, reability, and timeliness of patience test results
_____________. - CORRECT ANSWER regardless of where the test was performed.
The National Correct Coding Initiative (NCCI) promotes national correct coding
methodologies and eliminates improper coding. NCCI edits are developed based on coding
conventions defined in ________, current standards of medical and surgical coding practice,
input from societies societies, and analysis of current coding practice. - CORRECT
ANSWER CPT
The primary intent of HIPAA legislation is to ________________. - CORRECT
ANSWER Create better access to health insurance, limit fraud and abuse, and reduce
administrative cost.
Effective 2002, the utilization and quality control review of healthcare furnished, or to be
furnished, to Medicare beneficiaries is performed by ____________________. - CORRECT
ANSWER quality improvement organizations
Which is a primary purpose of the patient's record? - CORRECT ANSWER Ensure
continuity of care.
care Exam UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Which was the first commercial insurance company in the United States to provide private
health care coverage for injuries not result in death? - CORRECT ANSWER Franklin
health Assurance Company
Which replaced the 1908 workers compensation legislation and provided civilian employees
of the federal government with medical care, survivors benefits and compensation for lost
wages? - CORRECT ANSWER Federal Employees Compensation Act
The first Blue Cross policy was introduced by? - CORRECT ANSWER Baylor
University in Dallas Texas
The Blue Shield concept grew out of the lumber and mining camps of the _______ region at
the turn of the century. - CORRECT ANSWER Pacific Northwest
Health care coverage offered by ________ its called group health insurance. - CORRECT
ANSWER Employees
The Hill-Burton Act provided federal grants from modernizing hospitals that had become
obsolete because of lack of capital investment during the Great Depression and World War
and WWII (1929 to 1945). in return for federal funds, _______________. - CORRECT
ANSWER facilities were required to provide service free or at reduced rates to patients
unable to pay for care.
Third-party administrators (TPA's) administer health care plans and process claims, serving
as a _________________. - CORRECT ANSWER System of checks and balance for
labor and management.a
Major medical insurance provides coverage for_______________ illness and injuries,
incorporating large deductibles and lifetime maximum amount. - CORRECT
ANSWER catastrophic or prolonged.
, The government health plan that provides health care services to Americans over the age of
65 is called_____________________. - CORRECT ANSWER Medicare
The percentage of cost a patient shares with the health plan ( e.g., plan pays 80% of costs and
patient pays 20%) is called __________. - CORRECT ANSWER coinsurance.
The Tax Equity in Fiscal Responsibility Act of 1982 (TEFRA) enacted the _____________
prospective payment system (PPS). - CORRECT ANSWER diagnosis- related groups
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all
laboratories testing to ensure accuracy, reability, and timeliness of patience test results
_____________. - CORRECT ANSWER regardless of where the test was performed.
The National Correct Coding Initiative (NCCI) promotes national correct coding
methodologies and eliminates improper coding. NCCI edits are developed based on coding
conventions defined in ________, current standards of medical and surgical coding practice,
input from societies societies, and analysis of current coding practice. - CORRECT
ANSWER CPT
The primary intent of HIPAA legislation is to ________________. - CORRECT
ANSWER Create better access to health insurance, limit fraud and abuse, and reduce
administrative cost.
Effective 2002, the utilization and quality control review of healthcare furnished, or to be
furnished, to Medicare beneficiaries is performed by ____________________. - CORRECT
ANSWER quality improvement organizations
Which is a primary purpose of the patient's record? - CORRECT ANSWER Ensure
continuity of care.
