Chapter 14 and 15.Final Test Paper 2026\2027.
What is the statement from an insurance
company describing the amount paid, denied,
and applied to a person's deductible?
Explanation of benefit
The process of obtaining a dollar amount
approved for a medical procedure or service that
is to be scheduled is _______________.
precertification
A clearinghouse is a healthcare entity that acts as
an intermediary between the healthcare facility
and the ____________.
insurance company
Who is responsible for the entire medical bill?
Guarantor
Who pays allowable charges, or the maximum
amount of money paid for a service?
Third-party payer
What information goes into block 11 of a CMS
claim form?
Insurance group number
What is the statement from an insurance
company describing the amount paid, denied,
and applied to a person's deductible?
Explanation of benefit
The process of obtaining a dollar amount
approved for a medical procedure or service that
is to be scheduled is _______________.
precertification
A clearinghouse is a healthcare entity that acts as
an intermediary between the healthcare facility
and the ____________.
insurance company
Who is responsible for the entire medical bill?
Guarantor
Who pays allowable charges, or the maximum
amount of money paid for a service?
Third-party payer
What information goes into block 11 of a CMS
claim form?
Insurance group number
