Comprehensive Final - Results
Attempt 1 of 1
- 9
Attempt Score
8.67 %
- 9
Overall Grade (Highest Attempt)
8.67 %
Question 1 point
All of the following entities are voluntary healthcare insurance except:
Question options:
Private healthcare insurance plans
Commercial healthcare insurance plans
Medicare
Blue Cross and Blue Shield
Questio
point
n2
All of the following are discounted fee-for-service healthcare payment
methods except:
Question options:
ACO
CPR
RBRVS
UCR
,Questio
point
n3
The insurance analyst at the large group practice is responsible for issues
related to coordination of benefits. What does he or she do?
Question options:
Estimates the proportions of the payments from the primary and secondary
Arranges the healthcare for a patient across the continuum of care
Reconciles discrepancies between the explanation of benefits and the claim
Examines the exclusions and the clauses of pre-existing conditions and wait
policies
Questio
point
n4
In its payment notice (remittance advice), the healthcare plan lists that the
payment for the individual laboratory test is $39.00. The bill that the
pathologist's office submitted for the laboratory test was $45.00. What does
the amount of $39.00 represent?
Question options:
Cost
Allowable fee
Premium
Capitated rate
Questio
point
n5
The physician's office sent a request for payment to Able Insurance
Company. The term used in the healthcare industry for this request for
payment is a(n):
,Question options:
Allowance
Charge
Block grant
Claim
Questio
point
n6
Which governmental fraud and abuse effort focused on recouping lost funds
for the Medicare Program due to inaccurate coding and billing? $188
million were recovered during the first two years of this effort.
Question options:
Hospital Payment Monitoring Program
OIG Compliance Program Guidance
Operation Restore Trust
Medicare Integrity Program
Questio
point
n7
Which of the following characteristics is representative of commercial
healthcare insurances?
Question options:
National federation of forty independent, locally operated plans
Composed of geographic plans and the FEP
, For-profit in the private sector
Account for about one-fourth of US healthcare expenditures
Questio
point
n8
Which healthcare payment method does Medicare use to reimburse
physicians based on the cost of providing services in terms of effort,
overhead, and malpractice insurance?
Question options:
Global payment
Capitated rate
CPR
Resource-based relative value scale
Questio
point
n9
Which of the following is not a reason to perform case-mix analysis?
Question options:
Analyze reimbursement fluctuations
Determine the correct MS-DRG assignment for an encounter
Describe a population to be served
Identify differences in practice patterns or coding complexity
None of the above
Attempt 1 of 1
- 9
Attempt Score
8.67 %
- 9
Overall Grade (Highest Attempt)
8.67 %
Question 1 point
All of the following entities are voluntary healthcare insurance except:
Question options:
Private healthcare insurance plans
Commercial healthcare insurance plans
Medicare
Blue Cross and Blue Shield
Questio
point
n2
All of the following are discounted fee-for-service healthcare payment
methods except:
Question options:
ACO
CPR
RBRVS
UCR
,Questio
point
n3
The insurance analyst at the large group practice is responsible for issues
related to coordination of benefits. What does he or she do?
Question options:
Estimates the proportions of the payments from the primary and secondary
Arranges the healthcare for a patient across the continuum of care
Reconciles discrepancies between the explanation of benefits and the claim
Examines the exclusions and the clauses of pre-existing conditions and wait
policies
Questio
point
n4
In its payment notice (remittance advice), the healthcare plan lists that the
payment for the individual laboratory test is $39.00. The bill that the
pathologist's office submitted for the laboratory test was $45.00. What does
the amount of $39.00 represent?
Question options:
Cost
Allowable fee
Premium
Capitated rate
Questio
point
n5
The physician's office sent a request for payment to Able Insurance
Company. The term used in the healthcare industry for this request for
payment is a(n):
,Question options:
Allowance
Charge
Block grant
Claim
Questio
point
n6
Which governmental fraud and abuse effort focused on recouping lost funds
for the Medicare Program due to inaccurate coding and billing? $188
million were recovered during the first two years of this effort.
Question options:
Hospital Payment Monitoring Program
OIG Compliance Program Guidance
Operation Restore Trust
Medicare Integrity Program
Questio
point
n7
Which of the following characteristics is representative of commercial
healthcare insurances?
Question options:
National federation of forty independent, locally operated plans
Composed of geographic plans and the FEP
, For-profit in the private sector
Account for about one-fourth of US healthcare expenditures
Questio
point
n8
Which healthcare payment method does Medicare use to reimburse
physicians based on the cost of providing services in terms of effort,
overhead, and malpractice insurance?
Question options:
Global payment
Capitated rate
CPR
Resource-based relative value scale
Questio
point
n9
Which of the following is not a reason to perform case-mix analysis?
Question options:
Analyze reimbursement fluctuations
Determine the correct MS-DRG assignment for an encounter
Describe a population to be served
Identify differences in practice patterns or coding complexity
None of the above
