BILLING AND CODING BUNDLED
CERTIFICATION TEST 2026 QUESTIONS AND
VERIFIED ANSWERS ALREADY PASSED
◉ benefit.
Answer: In the insurance industry, the services or items covered in
an insurance policy.
◉ claim.
Answer: In the insurance industry, a request for payment of covered
benefits.
◉ dependent.
Answer: In health insurance, an individual who receives insurance
benefits due to a relationship to the subscriber (e.g., a child or
spouse).
◉ guarantor.
Answer: In health care, the person who is financially responsible to
pay a medical bill.
◉ premium.
,Answer: In the insurance industry, a monthly payment made to
purchase insurance coverage.
◉ deductible.
Answer: In the insurance industry, an amount that must be paid for
covered services by the subscriber before insurance benefits are
paid.
◉ copayment.
Answer: In healthcare insurance, a set amount that must be paid by
the subscriber for a covered service.
◉ coinsurance.
Answer: In healthcare insurance, a percentage of charges that must
be paid by the subscriber for a covered service.
◉ Patient Protection and Affordable Care Act (ACA).
Answer: A federal law enacted in 2010 with the goals of making
insurance affordable to more people, expanding Medicaid coverage,
and supporting care practices that improve patient health and lower
costs.
◉ out-of-pocket maximum.
, Answer: In healthcare insurance, a limit on the total amount a
subscriber must pay each year for covered services; after the
subscriber meets the out-of-pocket maximum, the insurer must pay
100% of covered costs.
◉ explanation of benefits (EOB).
Answer: A summary of coverage provided by an insurer to the
subscriber and the healthcare provider after an insurance claim is
made, including what portion of the charges are covered by
insurance and what portion must be paid by the patient.
◉ remittance advice (RA) statement.
Answer: A document provided by an insurer to a healthcare
provider summarizing a health insurance claim, including charges
that have been billed, what portion are covered by insurance, and
what portion must be paid by the patient.
◉ allowable amount.
Answer: A standard fee for a treatment, service, or supply set by an
insurer; providers contracted with an insurer are obliged to accept
this amount as payment.
◉ rider.
Answer: Something added to an insurance policy that changes the
terms of the policy, for example to add specific additional coverage.
CERTIFICATION TEST 2026 QUESTIONS AND
VERIFIED ANSWERS ALREADY PASSED
◉ benefit.
Answer: In the insurance industry, the services or items covered in
an insurance policy.
◉ claim.
Answer: In the insurance industry, a request for payment of covered
benefits.
◉ dependent.
Answer: In health insurance, an individual who receives insurance
benefits due to a relationship to the subscriber (e.g., a child or
spouse).
◉ guarantor.
Answer: In health care, the person who is financially responsible to
pay a medical bill.
◉ premium.
,Answer: In the insurance industry, a monthly payment made to
purchase insurance coverage.
◉ deductible.
Answer: In the insurance industry, an amount that must be paid for
covered services by the subscriber before insurance benefits are
paid.
◉ copayment.
Answer: In healthcare insurance, a set amount that must be paid by
the subscriber for a covered service.
◉ coinsurance.
Answer: In healthcare insurance, a percentage of charges that must
be paid by the subscriber for a covered service.
◉ Patient Protection and Affordable Care Act (ACA).
Answer: A federal law enacted in 2010 with the goals of making
insurance affordable to more people, expanding Medicaid coverage,
and supporting care practices that improve patient health and lower
costs.
◉ out-of-pocket maximum.
, Answer: In healthcare insurance, a limit on the total amount a
subscriber must pay each year for covered services; after the
subscriber meets the out-of-pocket maximum, the insurer must pay
100% of covered costs.
◉ explanation of benefits (EOB).
Answer: A summary of coverage provided by an insurer to the
subscriber and the healthcare provider after an insurance claim is
made, including what portion of the charges are covered by
insurance and what portion must be paid by the patient.
◉ remittance advice (RA) statement.
Answer: A document provided by an insurer to a healthcare
provider summarizing a health insurance claim, including charges
that have been billed, what portion are covered by insurance, and
what portion must be paid by the patient.
◉ allowable amount.
Answer: A standard fee for a treatment, service, or supply set by an
insurer; providers contracted with an insurer are obliged to accept
this amount as payment.
◉ rider.
Answer: Something added to an insurance policy that changes the
terms of the policy, for example to add specific additional coverage.
