QUESTIONS WITH ANSWERS GUARANTEE A+
✔✔Patients under the age of 65 who are blind or widowed or who have serious long-
term disabilities, such as chronic joint pain or _____, many also be entitled to Medicare.
- ✔✔kidney failure
✔✔Which of the following is included in Medicare benefits for respite care - ✔✔The
terminally ill patient is moved to a care facility for the respite
✔✔An organizations that provides pain relief to terminally ill patients and supports these
patients and their families is a - ✔✔hospice
✔✔The amount Medicare pays the physician or health-care provider after the $100
annual deductible is met is - ✔✔80%
✔✔Which of the following is included under Workers' Compensation insurance? -
✔✔Rehabilitation costs are covered to return an employee to work
✔✔Medicare encourages all practices to file claims electronically because - ✔✔the
process saves time
✔✔A characteristic of health maintenance organizations(HMO) is - ✔✔physicians with
HMO contracts are often paid a capitated rate
✔✔HMO copayments are often - ✔✔$10-$20
✔✔A husband and wife are both employed and have work-sponsored insurance plans
that cover each other and their three children. Which insurance plan is the primary
payer? - ✔✔the insurance plan of the person whose birthday comes first in the calendar
year
✔✔Electronic media claims (EMC) include - ✔✔data elements that are transmitted in a
computer file
✔✔An appropriate approach to maintaining patient confidentiality on the computer is to -
✔✔change your password every 90 days
✔✔Under a contracted or fixed prepayment called____, physicians are paid a fixed
amount of money to provide needed care. - ✔✔capitation
✔✔TRICARE and CHAMPVA cover - ✔✔families of all military personnel.
, ✔✔When entering data in medical billing programs, always - ✔✔enter information using
capital letters
✔✔The determination of the amount of money paid by a third-party papyer for a
procedure is - ✔✔pre-certification
✔✔What is the approval for payment from a third-party requested prior to a procedure?
- ✔✔pre-authorization
✔✔When a physician agrees to accept assignment, this means the physician - ✔✔will
accept the amount of money that Medicaid will pay as payment in full for the Medicaid
covered service
✔✔Eligibility for Medicaid is - ✔✔based on the patient's reported income from the
previous month
✔✔Which of the following is part of the process for verifying workers' compensation
coverage? - ✔✔obtaining the employer's approval to provide treatment
✔✔What is the term for the 10-digit number identifying the physician's medical
specialty? - ✔✔taxonomy code
✔✔What are usual fees that are listed on the office's fee schedule - ✔✔fee charged to
most of their patients most of the time under typical conditions
✔✔Which of the following must be verbally discussed with the beneficiary to enable the
beneficiary to consider options and make informed choices? - ✔✔ABN
✔✔If providers submit a claim for a simple procedure when in fact a more complicated
procedure was documented in the medical record,______may occur -
✔✔underpayment
✔✔Which of the following may occur when providers submit claims that do not meet
Medicare's coding or medical neccessity policies? - ✔✔denial of claim
✔✔The use of ICD-9 codes is mandated by - ✔✔HIPAA
✔✔A patient's diagnosis as established by the physician - ✔✔describes the primary
condition for which the patient is receiving treatment
✔✔ICD-9 codes are updated - ✔✔yearly
✔✔The Alphabetic Index is organized by - ✔✔the condition