NCCT Insurance Processing Exam with verified detailed answers

NCCT Insurance Processing Exam with verified detailed
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answers


Which of the following insurance related forms includes a detailed description of
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benefits paid, reduced, or denied on a claim? - ✔✔EOB (Explanation of Benefits)
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Which of the following types of coverage provide protection up to a maximum limit in
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cases of catastrophic or prolonged illness? - ✔✔Major medical
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Employees of a major automoblie manufacterer are provided health insurance under a
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master contract issued to their employer. Which of the following types of coverage
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does this reflect? - ✔✔Group policy
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The main purpose for verifying a patient's insurance coverage at every visit is to -
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✔✔prevent claim rejection due to ineligibility or non-active status.
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Which of the following forms should be transmitted to obtain reimbursement
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following a physician's office visit for a patient with active Medicaid coverage? -
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✔✔CMS-1500



Request for payment under the terms of a health insurance policy is referred to as
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which of the following? - ✔✔Claim
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Premiums are payments made systematically to insurance companies in exchange for
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which of the following? - ✔✔Benefits
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Which of the following forms should the medical assistant submit to request insurance
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reimbursement for a physician's office visit? - ✔✔CMS-1500
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, Which of the following patient documents should a medical office assistant refer to in
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order to complete the patient information question block section of the CMS-1500
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form? - ✔✔Registration form || || ||




For reimbursement purposes, the medical assistant should check to make sure that
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which of the following key pieces are provided on the insurance claim form? -
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✔✔ICD-9-CM and CPT Codes || || ||




A 64 year old indigent veteran ( recently diagnosed disabled but has a part-time job)
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receiving outpatient peritoneal dialysis was referred to his ferderal primary care
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provider for stomatitis. The patient then went to his PCP for an assessment plan and
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IV antibiotics. The patient died at 2:00pm the following day, on his 65th birthday.
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Which of the following entities should be billed for the medical expenses? - ✔✔Tricare
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Which type of insurance begins direct payment to the patient after they have been
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injured and unable to work for a specific period of time? - ✔✔Disability
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A patient sustained broken ribs in an automobile accident in which she was the
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passenger. After completion of an office follow up visit, which of the following should
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the medical office assistant submit the insurance claim to first? - ✔✔The driver's
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automobile insurance ||




Which of the following actions should the medical assistant take when handling a
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worker's compenstation claim? - ✔✔Promptly verify the patient's insurance coverage
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with their employer.
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Which is the correct procedure for keeping an industrial patient's financial and health
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records when the same physician is also seeing the patient as a private patient? -
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✔✔Separate financial and health records must be used. || || || || || || ||