MDAST 322 Chapter 12 Exam Graded
A+
Nearly all of the provider's income is derived from the insurance payments received for
services rendered. - Answer- True. Nearly all of the provider's income is derived from
the insurance payments received for services rendered.
Which part of Medicare covers prescription drug services? - Answer- D. Part D offers
Medicare recipients the option of choosing, at a reduced cost, a plan that pays for
prescription drugs with just a small copayment from the patient.
Health insurance typically covers services and procedures considered medically
necessary. Most insurance policies also cover "elective" procedures, such as certain
cosmetic surgeries, that are not considered medically necessary. - Answer- False. Most
health insurance plans do not cover "elective" procedures.
An order from a primary care provider for the patient to see a specialist is a(n): -
Answer- referral
The amount of money the policyholder pays per claim before the insurance company
will pay on the claim is known as the: - Answer- deductible
A designated person who receives funds from an insurance policy is: - Answer-
beneficiary
A formal request for payment from an insurance company for services provided is: -
Answer- claim
Which of the following is not a disadvantage of managed care? - Answer- Authorized
services usually are covered.
Which of the following referrals can be approved online when it is submitted through the
provider's web portal to the utilization review department? - Answer- STAT referral
Organizations that fund their own insurance programs offer their employees: - Answer-
self-funded plans
The federal- and state-sponsored health insurance program for the medically indigent is
called: - Answer- Medicaid
Which type of referral is usually processed immediately? - Answer- STAT
A review of individual cases by a committee to make sure that services are medically
necessary is called a(n): - Answer- utilization review
A+
Nearly all of the provider's income is derived from the insurance payments received for
services rendered. - Answer- True. Nearly all of the provider's income is derived from
the insurance payments received for services rendered.
Which part of Medicare covers prescription drug services? - Answer- D. Part D offers
Medicare recipients the option of choosing, at a reduced cost, a plan that pays for
prescription drugs with just a small copayment from the patient.
Health insurance typically covers services and procedures considered medically
necessary. Most insurance policies also cover "elective" procedures, such as certain
cosmetic surgeries, that are not considered medically necessary. - Answer- False. Most
health insurance plans do not cover "elective" procedures.
An order from a primary care provider for the patient to see a specialist is a(n): -
Answer- referral
The amount of money the policyholder pays per claim before the insurance company
will pay on the claim is known as the: - Answer- deductible
A designated person who receives funds from an insurance policy is: - Answer-
beneficiary
A formal request for payment from an insurance company for services provided is: -
Answer- claim
Which of the following is not a disadvantage of managed care? - Answer- Authorized
services usually are covered.
Which of the following referrals can be approved online when it is submitted through the
provider's web portal to the utilization review department? - Answer- STAT referral
Organizations that fund their own insurance programs offer their employees: - Answer-
self-funded plans
The federal- and state-sponsored health insurance program for the medically indigent is
called: - Answer- Medicaid
Which type of referral is usually processed immediately? - Answer- STAT
A review of individual cases by a committee to make sure that services are medically
necessary is called a(n): - Answer- utilization review
