RBS EXAM QUESTIONS AND ANSWERS
EXAM REVIEW UPDATED COMPLETE
QUESTIONS AND ANSWERS GRADED A+
◉ WHO IS COVERED BY CHAMPVA?
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES
AND THEIR FAMILIES
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
C) RETIRED MILITARY AND THEIR FAMILIES
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65. Answer: A)
VETERANS WITH SERVICE - CONNECTED DISABILITIES
AND THEIR FAMILIES
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL
PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS
(CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY
AND TOTALLY DISABLED DUE TO A SERVICE-RELATED
DISABILITY AND THEIR SPOUSE AND CHILDREN.
◉ PATIENT IS BROUGHT TO THE LOCAL URGENT CARE
AFTER FALLING FROM A LADDER WHILE HANGING
EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED A
CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS
COVERED BY HIS EMPLOYER'S GROUP HEALTH PLAN AND
,HE ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE
POLICY. WHICH INSURANCE SHOULD BE BILLED?
A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY
THE GROUP HEALTH PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS
PRIMARY AND LIST THE HOMEOWNER'S INSURANCE AS
SECONDARY.. Answer: B) THE EMPLOYER'S GROUP HEALTH
PLAN
RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED
FIRST AND THEN THROUGH THE PROCESS OF
SUBROGATION IT WILL BE DETERMINED IF A LIABILITY
PAYER SHOULD BE CONSIDERED PRIMARY.
◉ 3. PRIVATE COMPANIES CONTRACT WITH CMS TO
ADMINISTER:
A) MEDICARE PART A & B
B) MEDICARE PART B
C) MEDICARE PART C
D) MEDICARE PART A, B, & C. Answer: D) MEDICARE PART A,
B, AND C
,RATIONALE: MEDICARE PART A, B, AND C ARE ALL
ADMINISTERED BY PRIVATE COMPANIES THAT CONTRACT
WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS
OR MACs.
◉ WHAT IS A CO-PAYMENT?
A) AN AMOUNT PAID EVERY MONTH BY THE
POLICYHOLDER TO MAINTAIN HEALTH INSURANCE
COVERAGE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE
PATIENT IS RESPONSIBLE FOR.
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER
WHEN THE POLICYHOLDER IS SEEN FOR AN OFFICE VISIT.
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE
POLICY REQUIREMENT.. Answer: C) A FLAT AMOUNT PAID
TO THE HEALTHCARE PROVIDER WHEN THE POLICY
HOLDER IS SEEN FOR AN OFFICE VISIT.
◉ WHICH OF THE FOLLOWING STATEMENTS IS TRUE
REGARDING THE NON-PAR MEDICARE ALLOWED FEE
SCHEDULE?
A) THE NON-PAR PROVIDER CAN BILL THE PATIENT THE
DIFFERENCE BETWEEN THE CHARGE AND THE MEDICARE
ALLOWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
PAR MEDICARE PHYSICIAN FEE SCHEDULE
, C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF
THE PAR MEDICARE PHYSICIAN FEE SCHEDULE
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR
MEDICARE PHYSICIAN FEE SCHEDULE.. Answer: B) THE
NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR
MEDICARE PHYSICIAN FEE SCHEDULE.
RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS
115% OF THE NON-PAR MEDICARE PHYSICIAN FEE
SCHEDULE.
◉ WHAT IS A MEDIGAP POLICY?
A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT
MEDICARE DOES NOT COVER.
B) A POLICY THAT WILL NOT REIMBURSE FOR OUT-OF-
POCKET COSTS NOT COVERED BY MEDICARE
C) A SUPPLEMENTAL INSURANCE OFFERED BY CMS.
D) A POLICY REQUIRED BY MEDICARE.. Answer: A) A POLICY
THAT COVERS HEALTHCARE SERVICES THAT MEDICARE
DOES NOT COVER.
◉ MEDICARE PART A IS AVAILABLE TO INDIVIDUALS
UNDER THE AGE OF 65 WHO HAVE:
A) DIABETES MELLITUS TYPE I OR II
B) CKD (CHRONIC KIDNEY DISEASE)
EXAM REVIEW UPDATED COMPLETE
QUESTIONS AND ANSWERS GRADED A+
◉ WHO IS COVERED BY CHAMPVA?
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES
AND THEIR FAMILIES
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
C) RETIRED MILITARY AND THEIR FAMILIES
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65. Answer: A)
VETERANS WITH SERVICE - CONNECTED DISABILITIES
AND THEIR FAMILIES
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL
PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS
(CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY
AND TOTALLY DISABLED DUE TO A SERVICE-RELATED
DISABILITY AND THEIR SPOUSE AND CHILDREN.
◉ PATIENT IS BROUGHT TO THE LOCAL URGENT CARE
AFTER FALLING FROM A LADDER WHILE HANGING
EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED A
CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS
COVERED BY HIS EMPLOYER'S GROUP HEALTH PLAN AND
,HE ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE
POLICY. WHICH INSURANCE SHOULD BE BILLED?
A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY
THE GROUP HEALTH PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS
PRIMARY AND LIST THE HOMEOWNER'S INSURANCE AS
SECONDARY.. Answer: B) THE EMPLOYER'S GROUP HEALTH
PLAN
RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED
FIRST AND THEN THROUGH THE PROCESS OF
SUBROGATION IT WILL BE DETERMINED IF A LIABILITY
PAYER SHOULD BE CONSIDERED PRIMARY.
◉ 3. PRIVATE COMPANIES CONTRACT WITH CMS TO
ADMINISTER:
A) MEDICARE PART A & B
B) MEDICARE PART B
C) MEDICARE PART C
D) MEDICARE PART A, B, & C. Answer: D) MEDICARE PART A,
B, AND C
,RATIONALE: MEDICARE PART A, B, AND C ARE ALL
ADMINISTERED BY PRIVATE COMPANIES THAT CONTRACT
WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS
OR MACs.
◉ WHAT IS A CO-PAYMENT?
A) AN AMOUNT PAID EVERY MONTH BY THE
POLICYHOLDER TO MAINTAIN HEALTH INSURANCE
COVERAGE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE
PATIENT IS RESPONSIBLE FOR.
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER
WHEN THE POLICYHOLDER IS SEEN FOR AN OFFICE VISIT.
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE
POLICY REQUIREMENT.. Answer: C) A FLAT AMOUNT PAID
TO THE HEALTHCARE PROVIDER WHEN THE POLICY
HOLDER IS SEEN FOR AN OFFICE VISIT.
◉ WHICH OF THE FOLLOWING STATEMENTS IS TRUE
REGARDING THE NON-PAR MEDICARE ALLOWED FEE
SCHEDULE?
A) THE NON-PAR PROVIDER CAN BILL THE PATIENT THE
DIFFERENCE BETWEEN THE CHARGE AND THE MEDICARE
ALLOWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
PAR MEDICARE PHYSICIAN FEE SCHEDULE
, C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF
THE PAR MEDICARE PHYSICIAN FEE SCHEDULE
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR
MEDICARE PHYSICIAN FEE SCHEDULE.. Answer: B) THE
NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR
MEDICARE PHYSICIAN FEE SCHEDULE.
RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS
115% OF THE NON-PAR MEDICARE PHYSICIAN FEE
SCHEDULE.
◉ WHAT IS A MEDIGAP POLICY?
A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT
MEDICARE DOES NOT COVER.
B) A POLICY THAT WILL NOT REIMBURSE FOR OUT-OF-
POCKET COSTS NOT COVERED BY MEDICARE
C) A SUPPLEMENTAL INSURANCE OFFERED BY CMS.
D) A POLICY REQUIRED BY MEDICARE.. Answer: A) A POLICY
THAT COVERS HEALTHCARE SERVICES THAT MEDICARE
DOES NOT COVER.
◉ MEDICARE PART A IS AVAILABLE TO INDIVIDUALS
UNDER THE AGE OF 65 WHO HAVE:
A) DIABETES MELLITUS TYPE I OR II
B) CKD (CHRONIC KIDNEY DISEASE)
