NHA CMAA PRACTICE EXAM QUESTIONS AND
100% CORRECT ANSWERS
adjuster
A person who represents either party of an insurance claim is the:
A. doctor
B. adjuster
C. provider
D. subscriber
claim
A request for payment under an insurance contractor bond is called a(n):
A. insurance application
B. claim
C. dual choice request
D. total disability
premium
Payment made periodically to keep an insurance policy in force is called:
A. time limit
B. premium
C. coinsurance
D. fee for service
provider
A person or institution that gives medical care is a(n):
A. third-party payer
B. provider
C. adjuster
D. insurance agent
indemnities
Benefits that are made in the form of cash payments are known as:
A. indemnities
B. deductibles
C. medical co-pays
D. cash advances
deductible
An amount the insured must pay before policy benefits begin is called:
A. indemnity
,B. extended benefits
C. deductible
D. catastrophic
health maintenance organization
An organization that offers health insurance at a fixed monthly premium with little or no
deductible and works through a primary care provider is called a(n):
A. preferred provider
B. health maintenance organization
C. member physician
D. private health provider
outpatient
A patient receiving ambulatory care at a hospital or other health facility without being admitted a
bed patient is called a(n):
A. inpatient
B. outpatient
C. carrier
D. adjuster
partial disability
An injury that prevents a worker from performing one or more of the regular functions of his job
would be known as a :
A. partial disability
B. permanent disability
C. total disability
D. resultant disability
subscriber
One who belongs to a group insurance plan is called:
A. third-party payer
B. subscriber
C. carrier
D. no correct answer
benefits
A sum of money provided in an insurance policy, payable for covered services is called:
A. deductible
B. benefits
C. dues payable
D. premium
coordination of benefits
, To prevent the insured from receiving a duplicate payment for losses under more than one
insurance policy is called:
A. fee-for-service
B. hospital benefits
C. coordination of benefits
D. non duplication benefits
coinsurance
When a patient has health insurance, the percentage of covered services that is the responsibility
of the patient to pay is known as:
A. coinsurance
B. pre-defined policy
C. comprehensive
D. in percent policy
intervening cause
A defense against malpractice may include acts of independent agents that stand in the way of
the causal connection between the negligent act and the damage suffered. This is called
A. comparative negligence
B. tolling of the statute of limitations
C. intervening cause
D. assumption of the risk
E. contributory negligence
accident
An unexpected event which may cause injury is called:
A. dread disease rider
B. accident
C. adjuster
D. no correct answer
participating physician
A doctor who agrees to accept an insurance companies pre-established fee as the maximum
amount to be collected is called:
A. subscriber
B. claim representative
C. participating physician
D. adjuster
time limit
A notice of insurance claim or proof of loss must be filed within a designated_________ or it can
be denied:
A. waiting period
100% CORRECT ANSWERS
adjuster
A person who represents either party of an insurance claim is the:
A. doctor
B. adjuster
C. provider
D. subscriber
claim
A request for payment under an insurance contractor bond is called a(n):
A. insurance application
B. claim
C. dual choice request
D. total disability
premium
Payment made periodically to keep an insurance policy in force is called:
A. time limit
B. premium
C. coinsurance
D. fee for service
provider
A person or institution that gives medical care is a(n):
A. third-party payer
B. provider
C. adjuster
D. insurance agent
indemnities
Benefits that are made in the form of cash payments are known as:
A. indemnities
B. deductibles
C. medical co-pays
D. cash advances
deductible
An amount the insured must pay before policy benefits begin is called:
A. indemnity
,B. extended benefits
C. deductible
D. catastrophic
health maintenance organization
An organization that offers health insurance at a fixed monthly premium with little or no
deductible and works through a primary care provider is called a(n):
A. preferred provider
B. health maintenance organization
C. member physician
D. private health provider
outpatient
A patient receiving ambulatory care at a hospital or other health facility without being admitted a
bed patient is called a(n):
A. inpatient
B. outpatient
C. carrier
D. adjuster
partial disability
An injury that prevents a worker from performing one or more of the regular functions of his job
would be known as a :
A. partial disability
B. permanent disability
C. total disability
D. resultant disability
subscriber
One who belongs to a group insurance plan is called:
A. third-party payer
B. subscriber
C. carrier
D. no correct answer
benefits
A sum of money provided in an insurance policy, payable for covered services is called:
A. deductible
B. benefits
C. dues payable
D. premium
coordination of benefits
, To prevent the insured from receiving a duplicate payment for losses under more than one
insurance policy is called:
A. fee-for-service
B. hospital benefits
C. coordination of benefits
D. non duplication benefits
coinsurance
When a patient has health insurance, the percentage of covered services that is the responsibility
of the patient to pay is known as:
A. coinsurance
B. pre-defined policy
C. comprehensive
D. in percent policy
intervening cause
A defense against malpractice may include acts of independent agents that stand in the way of
the causal connection between the negligent act and the damage suffered. This is called
A. comparative negligence
B. tolling of the statute of limitations
C. intervening cause
D. assumption of the risk
E. contributory negligence
accident
An unexpected event which may cause injury is called:
A. dread disease rider
B. accident
C. adjuster
D. no correct answer
participating physician
A doctor who agrees to accept an insurance companies pre-established fee as the maximum
amount to be collected is called:
A. subscriber
B. claim representative
C. participating physician
D. adjuster
time limit
A notice of insurance claim or proof of loss must be filed within a designated_________ or it can
be denied:
A. waiting period
