NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
1. Place the options below in order
ABC
of claim submission, where all
Auto
insurances are relevant.
Human
Humana
a
ABC
Medicar
Auto
e
Medicai
Medicai
d
d
Medicar
It is highly unlikely that a patient would
e have
all four of these insurances. However, if they
do, the order in which the claims are
submitted is relevant. It is assumed that
since there is auto in- surance involved, that
this claim has to do with an automobile
accident. The auto insurance should be
filed first. Humana, a private payer,
should be filed next. Government
insurance, such as Medicare and
2. Eligibility for Medicaid may Medicaid, should always be sub- mitted
change as quickly as last. When both Medicare and Medicaid
A. daily. are valid, Medicaid should be billed last.
B. weekly.
C. monthly. C. monthly.
D. yearly. Medicaid coverage determination is
monthly. For example, if a person is eligible
3. Which of the following processes for coverage on April 2, they are also
re-
eligible for coverage on April 25. Eligibility
will not change more or less frequently
than monthly.
C. verification
,NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
quires checking and confirming that the The process of insurance verification
is the con-
patient is a member of the insurance firmation that the patient is a member
of the
plan and that the member identification insurance plan and that the
member identifica-
number is correct? tion number is correct. This process
A. precertification should be done every time the patient
B. prior comes to the oflce, as insurance can change
authorization at any time. Precertifi- cation is obtained
C. verification for particular services and is obtained
D. referral from the insurance company prior to
, NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
those services being rendered.
Precertification has to do with medical
necessity if it is deemed that the patient's
diagnosis is a proper reason to have a
service. Prior authorization is the approval
from the insurance company to provide a
service. A referral is required for some
patients to see a specialist. Not all
insurance policies require re- ferrals.
4. The patient is a 3-year-old. Both parents C. with the earlier birthday in the
year.
have private insurance coverage on the According to the birthday rule, the
primary in-
patient, and the mother has a father.
Health- care Savings Account. B. The mother's
The primary in- surance belongs insurance has a lower
to the parent deductible.
A. who was born first (oldest). C. The mother's birthday
B. with the Healthcare comes first in the
Savings Ac- count. calendar year.
C. with the earlier birthday in the
year.
D. with the best insurance benefit
cov- erage.
5. A child was seen by her
pediatrician. The child is covered
under both her fa- ther's and
mother's insurance. Accord- ing to
the "Birthday Rule," the mother's
insurance is primary. Why?
A. The mother is older than the
, NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
surance belongs to the parent with the earlier birthday
in the year. A Healthcare Savings Account is an account in
which a person saves money
to be spent on healthcare services which is not
connected to an insurance company. It does not matter
who is oldest or who has the best cover- age when it
comes to coordination of benefits.
C. The mother's birthday comes first in the calen- dar
year.
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
1. Place the options below in order
ABC
of claim submission, where all
Auto
insurances are relevant.
Human
Humana
a
ABC
Medicar
Auto
e
Medicai
Medicai
d
d
Medicar
It is highly unlikely that a patient would
e have
all four of these insurances. However, if they
do, the order in which the claims are
submitted is relevant. It is assumed that
since there is auto in- surance involved, that
this claim has to do with an automobile
accident. The auto insurance should be
filed first. Humana, a private payer,
should be filed next. Government
insurance, such as Medicare and
2. Eligibility for Medicaid may Medicaid, should always be sub- mitted
change as quickly as last. When both Medicare and Medicaid
A. daily. are valid, Medicaid should be billed last.
B. weekly.
C. monthly. C. monthly.
D. yearly. Medicaid coverage determination is
monthly. For example, if a person is eligible
3. Which of the following processes for coverage on April 2, they are also
re-
eligible for coverage on April 25. Eligibility
will not change more or less frequently
than monthly.
C. verification
,NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
quires checking and confirming that the The process of insurance verification
is the con-
patient is a member of the insurance firmation that the patient is a member
of the
plan and that the member identification insurance plan and that the
member identifica-
number is correct? tion number is correct. This process
A. precertification should be done every time the patient
B. prior comes to the oflce, as insurance can change
authorization at any time. Precertifi- cation is obtained
C. verification for particular services and is obtained
D. referral from the insurance company prior to
, NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
those services being rendered.
Precertification has to do with medical
necessity if it is deemed that the patient's
diagnosis is a proper reason to have a
service. Prior authorization is the approval
from the insurance company to provide a
service. A referral is required for some
patients to see a specialist. Not all
insurance policies require re- ferrals.
4. The patient is a 3-year-old. Both parents C. with the earlier birthday in the
year.
have private insurance coverage on the According to the birthday rule, the
primary in-
patient, and the mother has a father.
Health- care Savings Account. B. The mother's
The primary in- surance belongs insurance has a lower
to the parent deductible.
A. who was born first (oldest). C. The mother's birthday
B. with the Healthcare comes first in the
Savings Ac- count. calendar year.
C. with the earlier birthday in the
year.
D. with the best insurance benefit
cov- erage.
5. A child was seen by her
pediatrician. The child is covered
under both her fa- ther's and
mother's insurance. Accord- ing to
the "Birthday Rule," the mother's
insurance is primary. Why?
A. The mother is older than the
, NCCT REVIEW | MEDICAL INSURANCE EXAM WITH ALL CORRECT &
100% VERIFIED ANSWERS|LATEST UPDATE|ALREADY GRADED A+
surance belongs to the parent with the earlier birthday
in the year. A Healthcare Savings Account is an account in
which a person saves money
to be spent on healthcare services which is not
connected to an insurance company. It does not matter
who is oldest or who has the best cover- age when it
comes to coordination of benefits.
C. The mother's birthday comes first in the calen- dar
year.
