AMCA Billing & Coding Test - Questions With Correct
Solutions
What type of insurance allows treatment virtually anywhere with a high
deductible that policy holders are willing to pay?
a. COBRA
b. EPO
c. PPO
d. HMO Correct Answer - C
Veterans with service related disabilities are eligible for case under which of
the following programs:
a. CHAMPUS
b. Medicare
c. CHAMPVA
d. TRICARE Correct Answer - C
_______________________ is usually sponsored and partially paid by an employer.
a. TRICARE
b. Private Insurance
c. Group Health Insurance
d. Worker's Aide Correct Answer - C
______________________ are used to report encounters for circumstances other
than a disease or injury in the ICD-10-CM.
a. A codes
b. V codes
c. Z codes
d. E codes Correct Answer - D
The abbreviation PMPM stands for:
a. Per member per month
b. Provider membership per management
c. Provider management provider manual
d. Pre menstrual after midnight Correct Answer - A
Schedule of benefits means:
a. Coordination of benefits
,b. HMO
c. Medical service covered under the insured's policy
d. Managed care organization Correct Answer - C
Medicare is funded by:
a. State Funds
b. Federal Funds
c. Employers
d. The patient Correct Answer - B
Physicians establish a list of their usual fees for:
a. The charges they have written off
b. The procedures and services they frequently perform
c. Workers' Compensation patients
d. Their Medicare patients Correct Answer - B
The insurance carrier is allowed to use nay method to determine the amount
for a service, also known as the:
a. Allowed amount
b. Fee schedule
c. Deductible
d. Insurance premium Correct Answer - B
Which of the following statements is true under the doctrine of respondeat
superior?
a. The billing and coding specialist is superior to other members of the
medical staff
b. The billing and coding specialist is responsible for any errors made by the
medical staff
c. The physician is responsible for any errors made by the medical staff
d. The person who has been employed for the longest period of time is
responsible for any errors made by the medical staff Correct Answer - C
HIPAA, stands for which of the following?
a. Health Insurance Portability and Accountability Act
b. Health Insurance Privacy Assessment and Agreement
c. Health Insurance Privacy and Agreements
d. Health Insurance Practices and Agreements Correct Answer - A
, Information given by a patient to medical personnel that cannot be disclosed
without consent constitutes:
a. Judgment
b. Duty of care
c. Privileged communication
d. Negligence Correct Answer - C
Why is a superbill/encounter form an important document in the office?
a. It is used when considering purchasing medical billing software
b. It has information needed for vendors
c. It ensures the correct spelling of the patient's name
d. It ensures the correct patient data information and procedure codes
Correct Answer - D
Which of the following facilities does not use CMS-1500 forms?
a. ASC (Ambulatory Surgery Center)
b. Nursing Home
c. Acute care
d. Dialysis clinic Correct Answer - D
Physicians usually submit claims for patients and receive payments directly
for the payers. The policy holder authorizes this by signing and dating a:
a. Accept assignment
b. Schedule of benefits
c. Assignment of benefits
d. Encounter form Correct Answer - C
Under the HIPAA Privacy Rule, providers do not need specific authorization in
order to release a patients PHI for TPO purposes. What does TPO stand for?
a. Treatment, patient protection, operations
b. Treatment, payment and health care operations
c. Type of payment, patient and observation
d. Type of insurance, payment, and health care operations Correct Answer -
B
If both parents cover dependents on their plan, the child's primary insurance
is usually determined by the birthday rule. What is meant by the birthday
rule?
a. If the mother is older than the father than she is primary
Solutions
What type of insurance allows treatment virtually anywhere with a high
deductible that policy holders are willing to pay?
a. COBRA
b. EPO
c. PPO
d. HMO Correct Answer - C
Veterans with service related disabilities are eligible for case under which of
the following programs:
a. CHAMPUS
b. Medicare
c. CHAMPVA
d. TRICARE Correct Answer - C
_______________________ is usually sponsored and partially paid by an employer.
a. TRICARE
b. Private Insurance
c. Group Health Insurance
d. Worker's Aide Correct Answer - C
______________________ are used to report encounters for circumstances other
than a disease or injury in the ICD-10-CM.
a. A codes
b. V codes
c. Z codes
d. E codes Correct Answer - D
The abbreviation PMPM stands for:
a. Per member per month
b. Provider membership per management
c. Provider management provider manual
d. Pre menstrual after midnight Correct Answer - A
Schedule of benefits means:
a. Coordination of benefits
,b. HMO
c. Medical service covered under the insured's policy
d. Managed care organization Correct Answer - C
Medicare is funded by:
a. State Funds
b. Federal Funds
c. Employers
d. The patient Correct Answer - B
Physicians establish a list of their usual fees for:
a. The charges they have written off
b. The procedures and services they frequently perform
c. Workers' Compensation patients
d. Their Medicare patients Correct Answer - B
The insurance carrier is allowed to use nay method to determine the amount
for a service, also known as the:
a. Allowed amount
b. Fee schedule
c. Deductible
d. Insurance premium Correct Answer - B
Which of the following statements is true under the doctrine of respondeat
superior?
a. The billing and coding specialist is superior to other members of the
medical staff
b. The billing and coding specialist is responsible for any errors made by the
medical staff
c. The physician is responsible for any errors made by the medical staff
d. The person who has been employed for the longest period of time is
responsible for any errors made by the medical staff Correct Answer - C
HIPAA, stands for which of the following?
a. Health Insurance Portability and Accountability Act
b. Health Insurance Privacy Assessment and Agreement
c. Health Insurance Privacy and Agreements
d. Health Insurance Practices and Agreements Correct Answer - A
, Information given by a patient to medical personnel that cannot be disclosed
without consent constitutes:
a. Judgment
b. Duty of care
c. Privileged communication
d. Negligence Correct Answer - C
Why is a superbill/encounter form an important document in the office?
a. It is used when considering purchasing medical billing software
b. It has information needed for vendors
c. It ensures the correct spelling of the patient's name
d. It ensures the correct patient data information and procedure codes
Correct Answer - D
Which of the following facilities does not use CMS-1500 forms?
a. ASC (Ambulatory Surgery Center)
b. Nursing Home
c. Acute care
d. Dialysis clinic Correct Answer - D
Physicians usually submit claims for patients and receive payments directly
for the payers. The policy holder authorizes this by signing and dating a:
a. Accept assignment
b. Schedule of benefits
c. Assignment of benefits
d. Encounter form Correct Answer - C
Under the HIPAA Privacy Rule, providers do not need specific authorization in
order to release a patients PHI for TPO purposes. What does TPO stand for?
a. Treatment, patient protection, operations
b. Treatment, payment and health care operations
c. Type of payment, patient and observation
d. Type of insurance, payment, and health care operations Correct Answer -
B
If both parents cover dependents on their plan, the child's primary insurance
is usually determined by the birthday rule. What is meant by the birthday
rule?
a. If the mother is older than the father than she is primary
