MEDICAL BILLING AND CODING PRACTICE EXAM| MOSTLY
TESTED COMPLETE QUESTIONS AND ANSWERS | 2025 LATEST
UPDATED | GET IT CORRECT!!
What type of insurance allows treatment virtually anywhere with a high deductible that
policyholder are willing to pay? - Ans PPO
Veterans with service related disabilities are eligible for care under which of the following
programs: - Ans CHAMPVA
is usually sponsored and partially paid by an employer - Ans Group
Health Insurance
are used to report encounter for circumstances other than a
disease or injury in ICD-10-CM - Ans Z codes
The abbreviation PMPM stand for - Ans Per member per month
Schedule of benefits means: - Ans Medical service covered under the insured's policy
Medicare is funded by - Ans Federal funds
Physician's establish a list of their usual fees for? - Ans The procedures and services they
frequently perform
The insurance carrier is allowed to use any method to determine the amount for a service, also
known as th - Ans Allowed amount
, Which of the following statements is true under the doctrine of respondeat superior? - Ans The
physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following? - Ans Health Insurance Portability and Accountability
Act
Information given by a patient to medical personnel that cannot be disclosed without consent
constitutes - Ans Privileged communication
Why is a superbill/encounter form an important document in the office? - Ans It ensures the
correct patient data information and procedure codes
Which of the following facilities does not use CMS-1500 forms? - Ans Acute care
Physicians usually submit claims for patients and receive payments directly from the payers.
The policy holder authorized this by signing and dating a: - Ans Assignment of benefits
Under the HIPAA Privacy Rule, providers do not need specific authorization in order to release a
patient's PHI for TPO purposes. What does TPO stand for? - Ans Treatment, payment and health
care operations
If both parents cover dependents on their plan, the child's primary insurance is usually
determined by the birthday rule. What is meant by the birthday rule? - Ans The parent whose
birthday is earlier in the calendar year is the primary
There are three participants in the medical insurance relationship the first party, the second
party and the third party. Who is referred to as the second party? - Ans Physician
TESTED COMPLETE QUESTIONS AND ANSWERS | 2025 LATEST
UPDATED | GET IT CORRECT!!
What type of insurance allows treatment virtually anywhere with a high deductible that
policyholder are willing to pay? - Ans PPO
Veterans with service related disabilities are eligible for care under which of the following
programs: - Ans CHAMPVA
is usually sponsored and partially paid by an employer - Ans Group
Health Insurance
are used to report encounter for circumstances other than a
disease or injury in ICD-10-CM - Ans Z codes
The abbreviation PMPM stand for - Ans Per member per month
Schedule of benefits means: - Ans Medical service covered under the insured's policy
Medicare is funded by - Ans Federal funds
Physician's establish a list of their usual fees for? - Ans The procedures and services they
frequently perform
The insurance carrier is allowed to use any method to determine the amount for a service, also
known as th - Ans Allowed amount
, Which of the following statements is true under the doctrine of respondeat superior? - Ans The
physician is responsible for any errors made by the medical staff
HIPAA stands for which of the following? - Ans Health Insurance Portability and Accountability
Act
Information given by a patient to medical personnel that cannot be disclosed without consent
constitutes - Ans Privileged communication
Why is a superbill/encounter form an important document in the office? - Ans It ensures the
correct patient data information and procedure codes
Which of the following facilities does not use CMS-1500 forms? - Ans Acute care
Physicians usually submit claims for patients and receive payments directly from the payers.
The policy holder authorized this by signing and dating a: - Ans Assignment of benefits
Under the HIPAA Privacy Rule, providers do not need specific authorization in order to release a
patient's PHI for TPO purposes. What does TPO stand for? - Ans Treatment, payment and health
care operations
If both parents cover dependents on their plan, the child's primary insurance is usually
determined by the birthday rule. What is meant by the birthday rule? - Ans The parent whose
birthday is earlier in the calendar year is the primary
There are three participants in the medical insurance relationship the first party, the second
party and the third party. Who is referred to as the second party? - Ans Physician
