NCCT Interactive Review Medical Insurance Exam Actual 2025 Questions And Verified Answers Verified by Experts Guaranteed Success.pdf

NCCT Interactive Review Medical Insurance Exam Actual
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Questions And Verified Answers m m m m




Guaranteed Success m




1. Eligibility for Medicaid may change as quickly as
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Answer> monthly. m




2. Which of the following processes requires checking and confirming that the
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patient is a member of the insurance plan and that the member identificatio
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n number is correct?
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Answer> verification m




3. The patient is a 3-year-
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old. Both parents have private insurance coverage on the patient, and the mo
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ther has a Healthcare Savings Account. The primary insurance belongs to the
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parent
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Answer> with the earlier birthday in the year.
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4. A child was seen by her pediatrician. The child is covered under both he
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r father's and mother's insurance. According to the "Birthday Rule," the m
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other's insurance is primary. Why?
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Answer> The mother's birthday comes first in the calendar year.
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1m/m44

,5. Which of the following statements is true concerning a court order about
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children's health coverage after a divorce?
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Answer> Divorce rulings override the birthday rule.
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6. If a married couple is covered under both spouses' health insurance and
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m the husband is picking up a prescription for himself, he should
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Answer> use both of insurance benefits as they apply to this pharmacy purchas
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e.

7. A patient has just left the doctor's office with a new prescription after a
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scheduled follow up visit. If the patient's primary insurance covers the bill
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m completely, her secondary insurance policy
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Answer> will not be used for this visit.
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8. The Medicare Secondary Payer Questionnaire is a form that
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Answer> patients fill out to determine if there is other insurance designated as the
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m primary insurance.
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9. Which of the following should the insurance and coding specialist check in
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m order to determine which payer should be billed as primary or secondary?
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Answer> - m




m COB COB stands for Coordination of Benefits and determines the order in which t
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he insurance specialist should bill the payers.
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2m/m44

,10. Which of the following statements is true for an employee on Medicare if
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he chooses coverage under the employer's group plan?
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Answer> The group plan will be primary and Medicare will be secondary.
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11. Which of the following determines the primary policy if two plans cover a
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dependent child?
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Answer> The parent who has the first birthdate of the year.
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12. The patient had United Health Care HMO group insurance before she reti
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red. Today she presented her Medicare Part B insurance card and her husba
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nd's Blue Cross Blue Shield PPO group insurance card to the insurance and c
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oding specialist. Which of the following is the patient's primary insurance for t
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oday's visit? m




Answer> Blue Cross Blue Shield PPO m m m m m




Answer>


Medicare Part B is not primary when the patient is part of a group sponsored health
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plan. United Health Care HMO is not in effect as the scenario indicates that the
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patient "had" the plan. Blue Cross Blue Shield PPO is primary to Medicare when th
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e patient is part of a group sponsored health insurance plan and would be the corr
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ect response. Medicare Part A would not be correct because it is not mentioned in t
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he scenario and is not used for office (outpatient) services.
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3m/m44

, 13. A patient was hurt at work and seen in the physician's office today. The p
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atient is covered under Medicare and BCBS and is also covered under Work
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ers' Compensation for this injury. Which of the following is the primary insur
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ance and the secondary insurance?
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Answer> Worker's Compensation is the primary, BCBS is the secondary
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Answer>


The patient was injured at work so Worker's Compensation is the primary insurance
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carrier. Once the claim is processed through Worker's Compensation, it would follow
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the standard of the patient's health insurance claim process. Since the patient is w
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orking and covered under the employers' policy, the claim should be filed with BCB
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S as the next step of submission and the claim would be filed with Medicare last.
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14. Place the options below in order of claim submission, where all insurances
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m are relevant. (Click and drag the options in the left column to their correct p
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osition in the right column.) m m m m




Medicare, Medicaid, Humana, ABC Auto m m m m




Answer> ABC Auto, Humana, Medicare, Medicaid
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Answer>


It is highly unlikely that a patient would have all four of these insurances. However,
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4m/m44