Billing and coding exam style Questions with
Answers
What type of insurance allows treatment virtually anywhere with a high deductible
that policy holder are willing to pay?
EPO
COBRA
HMO
PPO
Ans: PPO
Veterans with service related disabilities are eligible for care under which of the
following programs:
Medicare
TRICARE
CHAMPVA
CHAMPUS
Ans: CHAMPVA
________ is usually sponsored and partially paid by an employer
TRICARE
Worker's Aide
Group Health Insurance
Private Insurance
Ans: Group Health Insurance
are used to report encounter for circumstances other than a disease or injury in ICD-
10-CM
A codes
V codes
E codes
Z codes
Ans: Z codes
The abbreviation PMPM stand for
Premenstrual after midnight
Per member per month
Provider membership per management
Provider management provider manual
Q&A
,Ans: Per member per month
Schedule of benefits means:
Managed care organization
Medical service covered under the insured's policy
HMO
Coordination of benefits
Ans: medical service covered under the insured's policy
Medicare is funded by:
Employers
Federal funds
State funds
The patient
Ans: Federal funds
Physicians establish a list of their usual fees for:
Their Medicare patients
The procedures and services they frequently perform
The charges they have written off
Worker's compensation patients
Ans: The procedures and services they frequently perform
Physician usually submit claims for patients and receive payments directly from the
payers. The policy holder authorized this by signing and dating a:
Assignment of benefits
Schedule of benefits
Encounter form
Accept assignment
Ans: Assignment of benefits
The insurance carrier is allowed to use any method to determine the amount for a
service, also known as the
Fee schedule
Allowed amount
Insurance premium
Deductible
Ans: Allowed amount
Which of the following statements is true under the doctrine of respondent
superior?
The person who has been employed for the longest period of time is responsible for
any errors made by the medical staff
Q&A
, The physician is responsible for any errors made by the medical staff
The billing and coding specialist is superior to other members of the medical staff
The billing and coding specialist is responsible for any errors made by the medical
staff
Ans: The physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following?
Health Insurance Portability and Accountability Act
Health Insurance Practices and Agreements
Health Insurance Privacy Assessment and Agreement
Health Insurance Privacy and Agreements
Ans: Health Insurance Portability and Accountability Act
Information given by a patient to medical personnel that cannot be disclosed
without consent constitutes
Duty of Care
Privileged communication
Negligence
Judgement
Ans: Privileged communication
Why is a superbill/encounter form an important document in the office?
It ensures the correct patient data information and procedure codes
It is used when considering purchasing medical billing software
It has information needed for vendors
It ensures the correct spelling of the patient's name
Ans: It ensures the correct patient data information and procedure codes
Which of the following facilities does not use CMS-1500 forms?
Nursing home
Dialysis clinic
Asc (Ambulatory Surgery Center)
acute care
Ans: dialysis clinic
Under the HIPAA Privacy Rule, providers do not need specific authorization in
order to release a patient's PHI for TPO purposes. What does TPO stand for?
Treatment, patient protection, operations
Type of payment, patient and observation
Type of insurance payment and health care operations
Q&A
Answers
What type of insurance allows treatment virtually anywhere with a high deductible
that policy holder are willing to pay?
EPO
COBRA
HMO
PPO
Ans: PPO
Veterans with service related disabilities are eligible for care under which of the
following programs:
Medicare
TRICARE
CHAMPVA
CHAMPUS
Ans: CHAMPVA
________ is usually sponsored and partially paid by an employer
TRICARE
Worker's Aide
Group Health Insurance
Private Insurance
Ans: Group Health Insurance
are used to report encounter for circumstances other than a disease or injury in ICD-
10-CM
A codes
V codes
E codes
Z codes
Ans: Z codes
The abbreviation PMPM stand for
Premenstrual after midnight
Per member per month
Provider membership per management
Provider management provider manual
Q&A
,Ans: Per member per month
Schedule of benefits means:
Managed care organization
Medical service covered under the insured's policy
HMO
Coordination of benefits
Ans: medical service covered under the insured's policy
Medicare is funded by:
Employers
Federal funds
State funds
The patient
Ans: Federal funds
Physicians establish a list of their usual fees for:
Their Medicare patients
The procedures and services they frequently perform
The charges they have written off
Worker's compensation patients
Ans: The procedures and services they frequently perform
Physician usually submit claims for patients and receive payments directly from the
payers. The policy holder authorized this by signing and dating a:
Assignment of benefits
Schedule of benefits
Encounter form
Accept assignment
Ans: Assignment of benefits
The insurance carrier is allowed to use any method to determine the amount for a
service, also known as the
Fee schedule
Allowed amount
Insurance premium
Deductible
Ans: Allowed amount
Which of the following statements is true under the doctrine of respondent
superior?
The person who has been employed for the longest period of time is responsible for
any errors made by the medical staff
Q&A
, The physician is responsible for any errors made by the medical staff
The billing and coding specialist is superior to other members of the medical staff
The billing and coding specialist is responsible for any errors made by the medical
staff
Ans: The physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following?
Health Insurance Portability and Accountability Act
Health Insurance Practices and Agreements
Health Insurance Privacy Assessment and Agreement
Health Insurance Privacy and Agreements
Ans: Health Insurance Portability and Accountability Act
Information given by a patient to medical personnel that cannot be disclosed
without consent constitutes
Duty of Care
Privileged communication
Negligence
Judgement
Ans: Privileged communication
Why is a superbill/encounter form an important document in the office?
It ensures the correct patient data information and procedure codes
It is used when considering purchasing medical billing software
It has information needed for vendors
It ensures the correct spelling of the patient's name
Ans: It ensures the correct patient data information and procedure codes
Which of the following facilities does not use CMS-1500 forms?
Nursing home
Dialysis clinic
Asc (Ambulatory Surgery Center)
acute care
Ans: dialysis clinic
Under the HIPAA Privacy Rule, providers do not need specific authorization in
order to release a patient's PHI for TPO purposes. What does TPO stand for?
Treatment, patient protection, operations
Type of payment, patient and observation
Type of insurance payment and health care operations
Q&A
