UHI- CH. 1-5 EXAM QUESTIONS AND ANSWERS
1. It is the process of reporting as numeric and alphanumeric
characters on the insurance claim which is called coding. - CORRECT ANSWER✅✅diagnosis and
procedures/services
2. Medical necessity - CORRECT ANSWER✅✅Involves linking every procedure or service code reported
on the claim to a condition code that justifies the necessity of performing that procedure or service.
3. Health insurance claim - CORRECT ANSWER✅✅It is submitted to the payer requesting
reimbursement.
4. when a health insurance plan's preauthorization requirements
are not met by providers: - CORRECT ANSWER✅✅payment of the claim is denied.
5. CPT - CORRECT ANSWER✅✅is a coding system used to report procedures and services on claims.
6. Remittance advice - CORRECT ANSWER✅✅payment information about a claim are found on this
document.
7. Embezzle - CORRECT ANSWER✅✅steal
8. Ethics - CORRECT ANSWER✅✅describes the principles of right or good conduct and include rules that
govern the conduct of members of a profession.
9. Patient confidentiality - CORRECT ANSWER✅✅each student internship must sign a nondisclosure
agreement for the sake of patients' protection.
10. ICD-1- PCS - CORRECT ANSWER✅✅is a coding system used to report procedures and services on
inpatient hospital claims.
, 11. Medical care - CORRECT ANSWER✅✅includes the identification of disease and the provision of care
and treatment to persons who are sick, injured, or concerned about their health status.
12. Preventive examination - CORRECT ANSWER✅✅It may specifically result in the early detection of
health problems, allowing less drastic and less expensive treatment options.
13. Group health insurance - CORRECT ANSWER✅✅a health insurance coverage is subsidized by
employers and other organizations.
14. Individual health insurance - CORRECT ANSWER✅✅this is purchased by families who do not have
access to employer subsidized coverage
15. ICD - CORRECT ANSWER✅✅International Classification of Diseases
16. ICD - CORRECT ANSWER✅✅is a classification system that was developed by WHO and used to
collect data for statistical puposes.
17. Deductible - CORRECT ANSWER✅✅is the amount for which the patient is financially responsible
before an insurance policy provides payment.
18. CHAMPVA - CORRECT ANSWER✅✅provides health care benefits for dependents of veterans rated
as 100 percent permanently and totally disabled as a result of service-connected conditions, veterans
who died as a result of service-connected conditions, and veterans who died on duty with less than 30
days of active service.
19. CMS-1500 - CORRECT ANSWER✅✅Medicare requires providers to submit this claim for payment of
outpatient and office services.
20. General health status - CORRECT ANSWER✅✅CPT includes a section called evaluation and
management (E/M), which describes patient encounters with providers for the purpose of the
evaluation and management.
1. It is the process of reporting as numeric and alphanumeric
characters on the insurance claim which is called coding. - CORRECT ANSWER✅✅diagnosis and
procedures/services
2. Medical necessity - CORRECT ANSWER✅✅Involves linking every procedure or service code reported
on the claim to a condition code that justifies the necessity of performing that procedure or service.
3. Health insurance claim - CORRECT ANSWER✅✅It is submitted to the payer requesting
reimbursement.
4. when a health insurance plan's preauthorization requirements
are not met by providers: - CORRECT ANSWER✅✅payment of the claim is denied.
5. CPT - CORRECT ANSWER✅✅is a coding system used to report procedures and services on claims.
6. Remittance advice - CORRECT ANSWER✅✅payment information about a claim are found on this
document.
7. Embezzle - CORRECT ANSWER✅✅steal
8. Ethics - CORRECT ANSWER✅✅describes the principles of right or good conduct and include rules that
govern the conduct of members of a profession.
9. Patient confidentiality - CORRECT ANSWER✅✅each student internship must sign a nondisclosure
agreement for the sake of patients' protection.
10. ICD-1- PCS - CORRECT ANSWER✅✅is a coding system used to report procedures and services on
inpatient hospital claims.
, 11. Medical care - CORRECT ANSWER✅✅includes the identification of disease and the provision of care
and treatment to persons who are sick, injured, or concerned about their health status.
12. Preventive examination - CORRECT ANSWER✅✅It may specifically result in the early detection of
health problems, allowing less drastic and less expensive treatment options.
13. Group health insurance - CORRECT ANSWER✅✅a health insurance coverage is subsidized by
employers and other organizations.
14. Individual health insurance - CORRECT ANSWER✅✅this is purchased by families who do not have
access to employer subsidized coverage
15. ICD - CORRECT ANSWER✅✅International Classification of Diseases
16. ICD - CORRECT ANSWER✅✅is a classification system that was developed by WHO and used to
collect data for statistical puposes.
17. Deductible - CORRECT ANSWER✅✅is the amount for which the patient is financially responsible
before an insurance policy provides payment.
18. CHAMPVA - CORRECT ANSWER✅✅provides health care benefits for dependents of veterans rated
as 100 percent permanently and totally disabled as a result of service-connected conditions, veterans
who died as a result of service-connected conditions, and veterans who died on duty with less than 30
days of active service.
19. CMS-1500 - CORRECT ANSWER✅✅Medicare requires providers to submit this claim for payment of
outpatient and office services.
20. General health status - CORRECT ANSWER✅✅CPT includes a section called evaluation and
management (E/M), which describes patient encounters with providers for the purpose of the
evaluation and management.
