HIMS 5620 Exam 1
In the US, healthcare is most often connected to employment. What is a downfall of
this approach?
A. Employers must provide the same coverage to all employees
B. If one loses their job, they also lose their health insurance
C. Healthcare costs are shared equally between employer and employee
D. Employees cannot choose their own healthcare providers
Answer: B
What is Medicare?
A. A private health insurance program for low-income families
B. A state-run health insurance program for children
C. A national health insurance program that provides health services to elderly and
other qualifying individuals
D. An employer-based health insurance benefit
Answer: C
What is insurance?
A. A government program that provides free healthcare
B. A system of reducing a person's exposure to risk of loss by having another party
assume the risk
C. A healthcare savings account managed by employers
D. A tax deduction for medical expenses
Answer: B
What is the maximum out of pocket?
A. The total amount paid in premiums annually
B. The amount paid before insurance coverage begins
,C. After hitting this amount, the policyholder is not liable for any cost sharing for the
rest of the year
D. The maximum amount an insurance company will pay per year
Answer: C
Which populations does the Indian Health Service (IHS) serve?
A. Low-income families and children
B. American Indians and Alaska Natives
C. Veterans and active military personnel
D. Elderly individuals over 65
Answer: B
What is reimbursement?
A. A refund given to patients for overpayment
B. Amount paid to a healthcare provider for services provided to a patient
C. The portion of healthcare costs paid by the government
D. Money returned to insurance companies by providers
Answer: B
What is a Preferred Provider Organization (PPO)?
A. A government healthcare agency for veterans
B. An entity that contracts with employers and insurance companies to render
healthcare services to a group of members
C. A type of Medicare supplement insurance
D. A nonprofit organization that provides free healthcare
Answer: B
What is a beneficiary?
A. A healthcare provider who accepts insurance
B. An insurance company representative
, C. An individual who is eligible for benefits from a health plan
D. An employer who provides health insurance
Answer: C
What is a third-party payer?
A. The patient's family member who pays medical bills
B. A government agency that regulates healthcare
C. An insurance company or health agency that pays the physician, clinic, or other
provider for care rendered to the patient
D. A medical billing company
Answer: C
What is a deductible?
A. The monthly payment for insurance coverage
B. Annual amount of money that the policyholder must pay before the health
insurance plan will assume its share of liability
C. The percentage of medical costs shared between patient and insurer
D. A tax deduction for healthcare expenses
Answer: B
What is the Federal Employees' Compensation Act (FECA)?
A. A program ensuring civilian federal employees receive benefits for work-related
injuries and illnesses
B. Health insurance for military families
C. A retirement benefit program for government workers
D. A tax incentive program for federal contractors
Answer: A
What are the three goals to producing a claim?
A. Fast, accurate, and profitable
In the US, healthcare is most often connected to employment. What is a downfall of
this approach?
A. Employers must provide the same coverage to all employees
B. If one loses their job, they also lose their health insurance
C. Healthcare costs are shared equally between employer and employee
D. Employees cannot choose their own healthcare providers
Answer: B
What is Medicare?
A. A private health insurance program for low-income families
B. A state-run health insurance program for children
C. A national health insurance program that provides health services to elderly and
other qualifying individuals
D. An employer-based health insurance benefit
Answer: C
What is insurance?
A. A government program that provides free healthcare
B. A system of reducing a person's exposure to risk of loss by having another party
assume the risk
C. A healthcare savings account managed by employers
D. A tax deduction for medical expenses
Answer: B
What is the maximum out of pocket?
A. The total amount paid in premiums annually
B. The amount paid before insurance coverage begins
,C. After hitting this amount, the policyholder is not liable for any cost sharing for the
rest of the year
D. The maximum amount an insurance company will pay per year
Answer: C
Which populations does the Indian Health Service (IHS) serve?
A. Low-income families and children
B. American Indians and Alaska Natives
C. Veterans and active military personnel
D. Elderly individuals over 65
Answer: B
What is reimbursement?
A. A refund given to patients for overpayment
B. Amount paid to a healthcare provider for services provided to a patient
C. The portion of healthcare costs paid by the government
D. Money returned to insurance companies by providers
Answer: B
What is a Preferred Provider Organization (PPO)?
A. A government healthcare agency for veterans
B. An entity that contracts with employers and insurance companies to render
healthcare services to a group of members
C. A type of Medicare supplement insurance
D. A nonprofit organization that provides free healthcare
Answer: B
What is a beneficiary?
A. A healthcare provider who accepts insurance
B. An insurance company representative
, C. An individual who is eligible for benefits from a health plan
D. An employer who provides health insurance
Answer: C
What is a third-party payer?
A. The patient's family member who pays medical bills
B. A government agency that regulates healthcare
C. An insurance company or health agency that pays the physician, clinic, or other
provider for care rendered to the patient
D. A medical billing company
Answer: C
What is a deductible?
A. The monthly payment for insurance coverage
B. Annual amount of money that the policyholder must pay before the health
insurance plan will assume its share of liability
C. The percentage of medical costs shared between patient and insurer
D. A tax deduction for healthcare expenses
Answer: B
What is the Federal Employees' Compensation Act (FECA)?
A. A program ensuring civilian federal employees receive benefits for work-related
injuries and illnesses
B. Health insurance for military families
C. A retirement benefit program for government workers
D. A tax incentive program for federal contractors
Answer: A
What are the three goals to producing a claim?
A. Fast, accurate, and profitable
