BCBS TEST QUESTIONS & ANSWERS SOLVED 100%
CORRECT.
Which plan is primary? When a patient is covered by her employer-sponsored
group plan and by a government plan (not affiliated with the employer).
Employer-sponsored plan
Which plan is primary? When a patient is covered by her employer's group
insurance plan and also, covered by her spouse's group plan.
Employer-sponsored plan
For treatment not covered by the insurance plan requires prospective
authorization, otherwise known as ...?
Precertification
101, 102, 103 and 104 are the four Federal enrollment options and considered
what ID number on BCBS Claims?
Group ID number
Blue Cross and Blue Shield plans originated as two separate entities selling what
type of health plans?
Pre-paid Medical
Where did the first Blue Shield plan originate?
Palo Alto, California
What are special contract clauses that stipulate additional coverage for health
care services?
Riders
Most BCBS plans policyholders are known as?
Members
What is the deadline for submitting, customarily?
One year from date of service
What clause always coverage for immediate treatment sought and received for
sudden, severe, and unexpected conditions that, if left untreated, would place the
patient's health in jeopardy?
Medical Emergency Care Rider
Hospitalization, laboratory services, x-ray services, surgical fees, assistant
surgeon fees, obstetric care, intensive care, newborn care and chemotherapy are
routine service covered by?
BCBS
What year did the American Hospital Association (AHA) become the approving
agency for accreditation of new prepaid hospitalization plans?
1939
What year did Blue Cross and Blue Shield merge into a single corporation called
BlueCross BlueShield Association?
1986
What year did Blue Cross and Blue Shield combine personnel under the
leadership of a single president, responsible to both boards of directors?
1977
CORRECT.
Which plan is primary? When a patient is covered by her employer-sponsored
group plan and by a government plan (not affiliated with the employer).
Employer-sponsored plan
Which plan is primary? When a patient is covered by her employer's group
insurance plan and also, covered by her spouse's group plan.
Employer-sponsored plan
For treatment not covered by the insurance plan requires prospective
authorization, otherwise known as ...?
Precertification
101, 102, 103 and 104 are the four Federal enrollment options and considered
what ID number on BCBS Claims?
Group ID number
Blue Cross and Blue Shield plans originated as two separate entities selling what
type of health plans?
Pre-paid Medical
Where did the first Blue Shield plan originate?
Palo Alto, California
What are special contract clauses that stipulate additional coverage for health
care services?
Riders
Most BCBS plans policyholders are known as?
Members
What is the deadline for submitting, customarily?
One year from date of service
What clause always coverage for immediate treatment sought and received for
sudden, severe, and unexpected conditions that, if left untreated, would place the
patient's health in jeopardy?
Medical Emergency Care Rider
Hospitalization, laboratory services, x-ray services, surgical fees, assistant
surgeon fees, obstetric care, intensive care, newborn care and chemotherapy are
routine service covered by?
BCBS
What year did the American Hospital Association (AHA) become the approving
agency for accreditation of new prepaid hospitalization plans?
1939
What year did Blue Cross and Blue Shield merge into a single corporation called
BlueCross BlueShield Association?
1986
What year did Blue Cross and Blue Shield combine personnel under the
leadership of a single president, responsible to both boards of directors?
1977
