BCBS TEST QUESTIONS AND
ANSWERS
Which plan is primary? When a patient is covered by her employer-sponsored group
plan and by a government plan (not affiliated with the employer). -ANSEmployer-
sponsored plan
Which plan is primary? When a patient is covered by her employer's group insurance
plan and also, covered by her spouse's group plan. -ANSEmployer-sponsored plan
For treatment not covered by the insurance plan requires prospective authorization,
otherwise known as ...? -ANSPrecertification
101, 102, 103 and 104 are the four Federal enrollment options and considered what ID
number on BCBS Claims? -ANSGroup ID number
Blue Cross and Blue Shield plans originated as two separate entities selling what type
of health plans? -ANSPre-paid Medical
Where did the first Blue Shield plan originate? -ANSPalo Alto, California
What are special contract clauses that stipulate additional coverage for health care
services? -ANSRiders
Most BCBS plans policyholders are known as? -ANSMembers
What is the deadline for submitting, customarily? -ANSOne year from date of service
What clause always coverage for immediate treatment sought and received for sudden,
severe, and unexpected conditions that, if left untreated, would place the patient's
health in jeopardy? -ANSMedical Emergency Care Rider
Hospitalization, laboratory services, x-ray services, surgical fees, assistant surgeon
fees, obstetric care, intensive care, newborn care and chemotherapy are routine service
covered by? -ANSBCBS
What year did the American Hospital Association (AHA) become the approving agency
for accreditation of new prepaid hospitalization plans? -ANS1939
What year did Blue Cross and Blue Shield merge into a single corporation called
BlueCross BlueShield Association? -ANS1986
ANSWERS
Which plan is primary? When a patient is covered by her employer-sponsored group
plan and by a government plan (not affiliated with the employer). -ANSEmployer-
sponsored plan
Which plan is primary? When a patient is covered by her employer's group insurance
plan and also, covered by her spouse's group plan. -ANSEmployer-sponsored plan
For treatment not covered by the insurance plan requires prospective authorization,
otherwise known as ...? -ANSPrecertification
101, 102, 103 and 104 are the four Federal enrollment options and considered what ID
number on BCBS Claims? -ANSGroup ID number
Blue Cross and Blue Shield plans originated as two separate entities selling what type
of health plans? -ANSPre-paid Medical
Where did the first Blue Shield plan originate? -ANSPalo Alto, California
What are special contract clauses that stipulate additional coverage for health care
services? -ANSRiders
Most BCBS plans policyholders are known as? -ANSMembers
What is the deadline for submitting, customarily? -ANSOne year from date of service
What clause always coverage for immediate treatment sought and received for sudden,
severe, and unexpected conditions that, if left untreated, would place the patient's
health in jeopardy? -ANSMedical Emergency Care Rider
Hospitalization, laboratory services, x-ray services, surgical fees, assistant surgeon
fees, obstetric care, intensive care, newborn care and chemotherapy are routine service
covered by? -ANSBCBS
What year did the American Hospital Association (AHA) become the approving agency
for accreditation of new prepaid hospitalization plans? -ANS1939
What year did Blue Cross and Blue Shield merge into a single corporation called
BlueCross BlueShield Association? -ANS1986
