Chapter 8 Insurance NRCAHA
Claims be rejected or underpaid if the CPT code - answer is not backed up with
documentation
The fixed amount of money that an insured patient is required to pay each time he or
she receives treatment is called the – answer co-payment
Julie Ann's is serving in the Marine Corps. Julie's medical care is covered by - answer
TRICARE
When the office accepts payments directly from the insurance company, it is called -
answer assignment of benefits.
The insurance plan for the indigent is - answer Medicaid
Margo and Rob both work and participate in the health insurance plans offered by their
separate employers. When Margo and Rob use their insurance, they are regulated by a
term known as - answer coordination of benefits
Under the HMO concept, there is only a - answer a co-payment
Patients who are injured at work and covered under worker's compensation should -
answerhave separate medical financial records
The federal insurance plan that provides for services for the elderly and disabled is -
answerMedicare
A good way to make sure that a patient's insurance information is correct is to -
answermake a photocopy of the patient's insurance card and keep it in the file.
There is a federally mandated and state-run children's health improvement program for
the so-called working poor. The program is known as - answerCHIP
In order to be used for a coding system, classification systems must be composed of -
answernumbers and letters
Medicare claims are administered by - answerCMS
The type of insurance plan that reimburses all or part of the costs of services, provided
that the charge is usual, customary and reasonable for that particular service in that part
of the country, is knowns as - answerfee-for-service
, Tom Bloom is a disabled serviceman whose disability is caused by service-related
injuries. What insurance plan covers his wife and children? - answerCHAMPVA
All insurance must be paid for. This payment is called the - answerpremium
Payments for claims under Medicare Part A are based on - answerDiagnostic-Related
Groups (DRGs)
The form is by hospitals which is basically a summary document that is supported by a
detailed bill is the - answerCMS-1450
The insurance plan that cares for families in which the member of the armed forces is
not on active duty and which charges an annual enrollment fee is - answerTRICARE
Prime
If a claim is rejected by the insurance company - answerthe reason for the rejection will
be on a remittance advice form, the claim should be resubmitted immediately, correcting
what was on the remittance advice form, the patient should not be notified
Insurance companies use diagnosis codes to determine - answerif the procedure that
was billed was medically justified
Some patients have both Medicare and Medicaid. If so, the patient's primary insurance
will be - answerMedicare
The doctor is reimbursed directly for his/her services by the insurance company if the
patient has - answersigned an assignment of benefits form.
When an insurance form has been completed and is ready to be submitted to the
insurance company, record of it should be made - answerin the claims register
Use of codes to classify diseases became necessary when it became mandatory to
define classifications on - answerMedicare Part B forms
When the insurance company pays 80% of the charge, and the patient pays the
remaining 20%, this is called - answerco-insurance
the model of an HMO in which the doctors are employees of a group practice that is
organized as a Corporation is a - answergroup practice model HMO
when a patient is covered by more than one insurance company, the medical assistant
needs to fill out a - answerform for each insurance, indicating which one is primary
When making an appointment for a patient who has a referral from a managed care
plan , the administrative assistant must make sure that - answerthe patient has a
complete referral form from the primary care doctor
Claims be rejected or underpaid if the CPT code - answer is not backed up with
documentation
The fixed amount of money that an insured patient is required to pay each time he or
she receives treatment is called the – answer co-payment
Julie Ann's is serving in the Marine Corps. Julie's medical care is covered by - answer
TRICARE
When the office accepts payments directly from the insurance company, it is called -
answer assignment of benefits.
The insurance plan for the indigent is - answer Medicaid
Margo and Rob both work and participate in the health insurance plans offered by their
separate employers. When Margo and Rob use their insurance, they are regulated by a
term known as - answer coordination of benefits
Under the HMO concept, there is only a - answer a co-payment
Patients who are injured at work and covered under worker's compensation should -
answerhave separate medical financial records
The federal insurance plan that provides for services for the elderly and disabled is -
answerMedicare
A good way to make sure that a patient's insurance information is correct is to -
answermake a photocopy of the patient's insurance card and keep it in the file.
There is a federally mandated and state-run children's health improvement program for
the so-called working poor. The program is known as - answerCHIP
In order to be used for a coding system, classification systems must be composed of -
answernumbers and letters
Medicare claims are administered by - answerCMS
The type of insurance plan that reimburses all or part of the costs of services, provided
that the charge is usual, customary and reasonable for that particular service in that part
of the country, is knowns as - answerfee-for-service
, Tom Bloom is a disabled serviceman whose disability is caused by service-related
injuries. What insurance plan covers his wife and children? - answerCHAMPVA
All insurance must be paid for. This payment is called the - answerpremium
Payments for claims under Medicare Part A are based on - answerDiagnostic-Related
Groups (DRGs)
The form is by hospitals which is basically a summary document that is supported by a
detailed bill is the - answerCMS-1450
The insurance plan that cares for families in which the member of the armed forces is
not on active duty and which charges an annual enrollment fee is - answerTRICARE
Prime
If a claim is rejected by the insurance company - answerthe reason for the rejection will
be on a remittance advice form, the claim should be resubmitted immediately, correcting
what was on the remittance advice form, the patient should not be notified
Insurance companies use diagnosis codes to determine - answerif the procedure that
was billed was medically justified
Some patients have both Medicare and Medicaid. If so, the patient's primary insurance
will be - answerMedicare
The doctor is reimbursed directly for his/her services by the insurance company if the
patient has - answersigned an assignment of benefits form.
When an insurance form has been completed and is ready to be submitted to the
insurance company, record of it should be made - answerin the claims register
Use of codes to classify diseases became necessary when it became mandatory to
define classifications on - answerMedicare Part B forms
When the insurance company pays 80% of the charge, and the patient pays the
remaining 20%, this is called - answerco-insurance
the model of an HMO in which the doctors are employees of a group practice that is
organized as a Corporation is a - answergroup practice model HMO
when a patient is covered by more than one insurance company, the medical assistant
needs to fill out a - answerform for each insurance, indicating which one is primary
When making an appointment for a patient who has a referral from a managed care
plan , the administrative assistant must make sure that - answerthe patient has a
complete referral form from the primary care doctor
