Medical Billing Final Exam with all Correct & 100%
Verified Answers |Latest Version |Already Graded A+
(Just Released)
When does the physician/patient contract begin? ✔Correct Answer-When the physician accepts
the patient and agrees to treat the patient
Most physician/patient contracts are ✔Correct Answer-implied
When a patient carries private medical insurance, the contract for treatment exists between the
✔Correct Answer-physician and the patient
An emancipated minor is ✔Correct Answer-A person younger than age 18, living independently
The contract in a workers' compensation case exists between the ✔Correct Answer-physician and
the insurance company
In cases of divorce, the decision as to which parent should be responsible for payment of the child's
services should be made by the ✔Correct Answer-court system
If a child has health insurance coverage from two parents, according to the birthday law ✔Correct
Answer-the health plan of the person whose birthday (month and day) falls earlier in the calendar
year will pay first
According to the birthday law, if both the mother and the father have the same birthday ✔Correct
Answer-plan of the person who has coverage longer is the primary payer
The patient protection and affordable care act (PPACA) and the health care and education
reconciliation act of 2010 (HCERA), together, are commonly referred to as ✔Correct Answer-
Affordable Care Act
A Key provision to the affordable care act is the creation of central clearinghouses that offer "one-
stop shopping" for purchasing health insurance coverage, which are known as ✔Correct Answer-
Exchanges
The amount that must be paid each year by the insured before policy benefits begin is known as the
✔Correct Answer-Deductible
When the insured is required to pay a percentage of the covered services cost, this is referred to as
✔Correct Answer-Cost-Sharing
Electronic billers are permitted to obtain a ________________ authorization from the patient to
release medical information necessary to process a claim ✔Correct Answer-Lifetime
The Government-sponsored program that provides hospital and medical services for dependents of
active duty uniform service members, military retirees and their families, and survivors of uniformed
services is called: ✔Correct Answer-TRICARE
,_________________ provides coverage for spouses and children of veterans with total, permanent,
service-connected disabilities or for the surviving spouses and children of veterans who died as a
result of service-connected disabilities. ✔Correct Answer-CHAMPVA
A form of health insurance that provides periodic payments to replace income with the insured is
unable to work as a result of illness, injury, or disease is called: ✔Correct Answer-Disability Income
Insurance
A medical capitation plan in which treatment is delivered via a clinic or independent physician that
provides a number of basic medical services for a fixed capitation payment per month is known as:
✔Correct Answer-Independent Practice Association (IPA)
The supreme court deemed the affordable care act's requirement to require individuals to have
health insurance coverage or face a penalty as unconstitutional- True or False? ✔Correct Answer-
False
An insurance billing specialist can escape liability by pleading ignorance- True or False? ✔Correct
Answer-False
Parents of an emancipated college student who is living away from home are liable for the medical
expenses incurred by their financially dependent child- True or False? ✔Correct Answer-False
The focus on the health care practice setting and reducing administrative costs and burdens are the
goals of ______________ ✔Correct Answer-HIPAA Title II Administrative Simplification
The office of the civil rights enforces what? ✔Correct Answer-Privacy and security rules
Confidential information includes: ✔Correct Answer-Everything that is heard about a patient
everything that is read about a patient
everything that is seen regarding a patient
What is the correct response when a relative calls asking about a patient? ✔Correct Answer-Have
the physician return the telephone call
Non-privileged information about a patient consists of the patient's ✔Correct Answer-City of
residence
Confidentiality is automatically waived in cases of: ✔Correct Answer-Gunshot wounds
Child Abuse
Extremely Contagious Diseases
What is the best response when telephoning a patient about an insurance matter and the patient's
voicemail is reached? ✔Correct Answer-Leave your name, the practice's name, and practice's
phone number, but do not leave any other information
Who said "what I may see or hear in the course of the treatment or even outside of the treatment in
regard to the life of men, which on no account one must spread abroad, I will keep to myself holding
such things shameful to be spoken about,"? ✔Correct Answer-Hippocrates
Non-privileged Information consists of ordinary ______________ unrelated to the treatment of the
patient ✔Correct Answer-Facts
, Telephone conversations by providers in front of patients should be _____________ ✔Correct
Answer-Avoided
A healthcare coverage carrier, clearinghouse, or physician who transmits health information in
electronic form in connection with a transaction covered by HIPAA is known as a
________________________? ✔Correct Answer-Covered Entity
An individual who renders medical services, furnishes bills, or is paid for health care in the normal
course of business is known as a? ✔Correct Answer-Health Care Provider
Third-party administrator who receives insurance claims from the physician's office, performs edits,
and redistributes the claims electronically to various insurance carriers is a ___________________
✔Correct Answer-Clearinghouse
An individual who is hired by a medical practice to process claims to a third-party payer is a
_________________ ✔Correct Answer-Business Associate
Under HIPAA guidelines, an outside billing company that manages claims and accounts for a medical
clinic is known as a covered entity- True or False? ✔Correct Answer-False
Under HIPAA guidelines, a chiropractor or dentist's office would never be considered a covered
entity- True or False? ✔Correct Answer-False
To give, release, or transfer information to another entity is called consent- True or False?
✔Correct Answer-False
To bill Medicare beneficiaries at a higher rate than other patients is considered what? ✔Correct
Answer-Abuse
When an insurance billing specialist bills for a physician and completes a Medicare claim form with
information that does not reflect the true situation, he or she may be ________________
✔Correct Answer-Subject to fines and imprisonment
What action could happen if an employee knowingly submits a fraudulent Medicare or Medicaid
claim at the direction of the employer and subsequently the medical practice is audited? ✔Correct
Answer-The employee and employer could be brought into litigation by the state or federal
government.
What would NOT typically be considered a form of discipline for situations that involve fraudulent
and malicious misconduct? ✔Correct Answer-Verbal warning
Billing for services not provided is an example of ✔Correct Answer-Fraud
A billing practice such as excessive referrals to other providers for unnecessary services is considered
__________________ ✔Correct Answer-Abuse
Stealing money that has be entrusted to one's care is know as ✔Correct Answer-Embezzlement
A health care organization must not conduct business with any health care provider who has been
listed as a _____________ by OIG? ✔Correct Answer-Excluded Individual
Verified Answers |Latest Version |Already Graded A+
(Just Released)
When does the physician/patient contract begin? ✔Correct Answer-When the physician accepts
the patient and agrees to treat the patient
Most physician/patient contracts are ✔Correct Answer-implied
When a patient carries private medical insurance, the contract for treatment exists between the
✔Correct Answer-physician and the patient
An emancipated minor is ✔Correct Answer-A person younger than age 18, living independently
The contract in a workers' compensation case exists between the ✔Correct Answer-physician and
the insurance company
In cases of divorce, the decision as to which parent should be responsible for payment of the child's
services should be made by the ✔Correct Answer-court system
If a child has health insurance coverage from two parents, according to the birthday law ✔Correct
Answer-the health plan of the person whose birthday (month and day) falls earlier in the calendar
year will pay first
According to the birthday law, if both the mother and the father have the same birthday ✔Correct
Answer-plan of the person who has coverage longer is the primary payer
The patient protection and affordable care act (PPACA) and the health care and education
reconciliation act of 2010 (HCERA), together, are commonly referred to as ✔Correct Answer-
Affordable Care Act
A Key provision to the affordable care act is the creation of central clearinghouses that offer "one-
stop shopping" for purchasing health insurance coverage, which are known as ✔Correct Answer-
Exchanges
The amount that must be paid each year by the insured before policy benefits begin is known as the
✔Correct Answer-Deductible
When the insured is required to pay a percentage of the covered services cost, this is referred to as
✔Correct Answer-Cost-Sharing
Electronic billers are permitted to obtain a ________________ authorization from the patient to
release medical information necessary to process a claim ✔Correct Answer-Lifetime
The Government-sponsored program that provides hospital and medical services for dependents of
active duty uniform service members, military retirees and their families, and survivors of uniformed
services is called: ✔Correct Answer-TRICARE
,_________________ provides coverage for spouses and children of veterans with total, permanent,
service-connected disabilities or for the surviving spouses and children of veterans who died as a
result of service-connected disabilities. ✔Correct Answer-CHAMPVA
A form of health insurance that provides periodic payments to replace income with the insured is
unable to work as a result of illness, injury, or disease is called: ✔Correct Answer-Disability Income
Insurance
A medical capitation plan in which treatment is delivered via a clinic or independent physician that
provides a number of basic medical services for a fixed capitation payment per month is known as:
✔Correct Answer-Independent Practice Association (IPA)
The supreme court deemed the affordable care act's requirement to require individuals to have
health insurance coverage or face a penalty as unconstitutional- True or False? ✔Correct Answer-
False
An insurance billing specialist can escape liability by pleading ignorance- True or False? ✔Correct
Answer-False
Parents of an emancipated college student who is living away from home are liable for the medical
expenses incurred by their financially dependent child- True or False? ✔Correct Answer-False
The focus on the health care practice setting and reducing administrative costs and burdens are the
goals of ______________ ✔Correct Answer-HIPAA Title II Administrative Simplification
The office of the civil rights enforces what? ✔Correct Answer-Privacy and security rules
Confidential information includes: ✔Correct Answer-Everything that is heard about a patient
everything that is read about a patient
everything that is seen regarding a patient
What is the correct response when a relative calls asking about a patient? ✔Correct Answer-Have
the physician return the telephone call
Non-privileged information about a patient consists of the patient's ✔Correct Answer-City of
residence
Confidentiality is automatically waived in cases of: ✔Correct Answer-Gunshot wounds
Child Abuse
Extremely Contagious Diseases
What is the best response when telephoning a patient about an insurance matter and the patient's
voicemail is reached? ✔Correct Answer-Leave your name, the practice's name, and practice's
phone number, but do not leave any other information
Who said "what I may see or hear in the course of the treatment or even outside of the treatment in
regard to the life of men, which on no account one must spread abroad, I will keep to myself holding
such things shameful to be spoken about,"? ✔Correct Answer-Hippocrates
Non-privileged Information consists of ordinary ______________ unrelated to the treatment of the
patient ✔Correct Answer-Facts
, Telephone conversations by providers in front of patients should be _____________ ✔Correct
Answer-Avoided
A healthcare coverage carrier, clearinghouse, or physician who transmits health information in
electronic form in connection with a transaction covered by HIPAA is known as a
________________________? ✔Correct Answer-Covered Entity
An individual who renders medical services, furnishes bills, or is paid for health care in the normal
course of business is known as a? ✔Correct Answer-Health Care Provider
Third-party administrator who receives insurance claims from the physician's office, performs edits,
and redistributes the claims electronically to various insurance carriers is a ___________________
✔Correct Answer-Clearinghouse
An individual who is hired by a medical practice to process claims to a third-party payer is a
_________________ ✔Correct Answer-Business Associate
Under HIPAA guidelines, an outside billing company that manages claims and accounts for a medical
clinic is known as a covered entity- True or False? ✔Correct Answer-False
Under HIPAA guidelines, a chiropractor or dentist's office would never be considered a covered
entity- True or False? ✔Correct Answer-False
To give, release, or transfer information to another entity is called consent- True or False?
✔Correct Answer-False
To bill Medicare beneficiaries at a higher rate than other patients is considered what? ✔Correct
Answer-Abuse
When an insurance billing specialist bills for a physician and completes a Medicare claim form with
information that does not reflect the true situation, he or she may be ________________
✔Correct Answer-Subject to fines and imprisonment
What action could happen if an employee knowingly submits a fraudulent Medicare or Medicaid
claim at the direction of the employer and subsequently the medical practice is audited? ✔Correct
Answer-The employee and employer could be brought into litigation by the state or federal
government.
What would NOT typically be considered a form of discipline for situations that involve fraudulent
and malicious misconduct? ✔Correct Answer-Verbal warning
Billing for services not provided is an example of ✔Correct Answer-Fraud
A billing practice such as excessive referrals to other providers for unnecessary services is considered
__________________ ✔Correct Answer-Abuse
Stealing money that has be entrusted to one's care is know as ✔Correct Answer-Embezzlement
A health care organization must not conduct business with any health care provider who has been
listed as a _____________ by OIG? ✔Correct Answer-Excluded Individual
