1|Page
Certified Construction Industry Financial
Professional (CCIFP) Certification Practice Test with
250+ Questions and Correct Answers/ CCIFP Exam
prep
Provider - general - ...ANSWER...✓✓ a licensed
professional or entity that provides a medical service to a
patient.
Facility provider - ...ANSWER...✓✓ an acute care hospital,
long-term care hospital, inpatient rehab hospital,
psychiatric facility, skilled nursing facility, assisted living
facility, home health agency, hospice agency, clinic or
ambulatory surgery center.
Professional provider - ...ANSWER...✓✓ a physician,
pharmacist, registered nurse or allied professional
provider (APP) rendering a medical service to a patient.
(Clinical social workers and physical therapists are
examples of APPs).
Primary care - ...ANSWER...✓✓ trained and board-
certified in family practice, general practice, general
internal medicine and pediatrics. They frequently
,2|Page
coordinate a patient's care and refer patients to
specialists.
Specialist - ...ANSWER...✓✓ a physician who specializes
in a specific disease, body system or type of healthcare.
Third-party payer - ...ANSWER...✓✓ a health insurance
plan paying a provider for healthcare services delivered
to its insured patients. The other two parties in a
healthcare business transaction are the patient and the
provider.
Out-of-pocket payment - ...ANSWER...✓✓ Payments
made by patients in addition to what their health
insurance plan pays
Deductible - ...ANSWER...✓✓ a pre-determined amount
that the patient pays before the insurer begins to pay for
service.
Coinsurance - ...ANSWER...✓✓ a percentage of the
insurance payment amount that is paid by the patient,
along with the amount paid by the insurer.
,3|Page
Copay - ...ANSWER...✓✓ a flat amount that a patient pays
at each time of service.
Claim - ...ANSWER...✓✓ another word for a bill for
healthcare services provided.
Pre-authorization - ...ANSWER...✓✓ Insurers may require
providers to contact them to pre- authorize certain high-
cost services before treatment. An acknowledgement by
the payer that it considers the service medically
necessary and will pay for it.
Benefit payment - ...ANSWER...✓✓ Once the insurer has
determined the claim is appropriate, a payment is made
to the provider. This payment is officially termed a
______________ _____________.
Beneficiary - ...ANSWER...✓✓ Insurers usually refer to
the patient for which services are paid as the
_____________.
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Covered benefit - ...ANSWER...✓✓ The services for which
the insurer will pay
Denial - ...ANSWER...✓✓ The insurer may determine that
the claim from the provider is not a covered benefit and
will not pay the claim.
Remittance advice - ...ANSWER...✓✓ a written
explanation accompanying an insurer's payment (or non-
payment) of a patient account to a provider. The copy sent
to the patient is known an Explanation of Benefits (EOB).
Medicare Part A (Hospital Insurance) - ...ANSWER...✓✓
one of two parts of the original Medicare program
established by Title XVIII of the Social Security Act in 1965.
It pays for hospital inpatient, skilled nursing facility,
hospice and some home health care. It's is a premium-
free benefit funded by FICA payroll deductions.
"Categorical" eligibility starts on when a U.S citizen who
paid FICA taxes for at least 40 calendar quarters turns 65.
Disabled individuals under 65 who have received Social
Security for 24 months also qualify for Medicare. Funded
by a 2.9% payroll tax.
Certified Construction Industry Financial
Professional (CCIFP) Certification Practice Test with
250+ Questions and Correct Answers/ CCIFP Exam
prep
Provider - general - ...ANSWER...✓✓ a licensed
professional or entity that provides a medical service to a
patient.
Facility provider - ...ANSWER...✓✓ an acute care hospital,
long-term care hospital, inpatient rehab hospital,
psychiatric facility, skilled nursing facility, assisted living
facility, home health agency, hospice agency, clinic or
ambulatory surgery center.
Professional provider - ...ANSWER...✓✓ a physician,
pharmacist, registered nurse or allied professional
provider (APP) rendering a medical service to a patient.
(Clinical social workers and physical therapists are
examples of APPs).
Primary care - ...ANSWER...✓✓ trained and board-
certified in family practice, general practice, general
internal medicine and pediatrics. They frequently
,2|Page
coordinate a patient's care and refer patients to
specialists.
Specialist - ...ANSWER...✓✓ a physician who specializes
in a specific disease, body system or type of healthcare.
Third-party payer - ...ANSWER...✓✓ a health insurance
plan paying a provider for healthcare services delivered
to its insured patients. The other two parties in a
healthcare business transaction are the patient and the
provider.
Out-of-pocket payment - ...ANSWER...✓✓ Payments
made by patients in addition to what their health
insurance plan pays
Deductible - ...ANSWER...✓✓ a pre-determined amount
that the patient pays before the insurer begins to pay for
service.
Coinsurance - ...ANSWER...✓✓ a percentage of the
insurance payment amount that is paid by the patient,
along with the amount paid by the insurer.
,3|Page
Copay - ...ANSWER...✓✓ a flat amount that a patient pays
at each time of service.
Claim - ...ANSWER...✓✓ another word for a bill for
healthcare services provided.
Pre-authorization - ...ANSWER...✓✓ Insurers may require
providers to contact them to pre- authorize certain high-
cost services before treatment. An acknowledgement by
the payer that it considers the service medically
necessary and will pay for it.
Benefit payment - ...ANSWER...✓✓ Once the insurer has
determined the claim is appropriate, a payment is made
to the provider. This payment is officially termed a
______________ _____________.
Beneficiary - ...ANSWER...✓✓ Insurers usually refer to
the patient for which services are paid as the
_____________.
, 4|Page
Covered benefit - ...ANSWER...✓✓ The services for which
the insurer will pay
Denial - ...ANSWER...✓✓ The insurer may determine that
the claim from the provider is not a covered benefit and
will not pay the claim.
Remittance advice - ...ANSWER...✓✓ a written
explanation accompanying an insurer's payment (or non-
payment) of a patient account to a provider. The copy sent
to the patient is known an Explanation of Benefits (EOB).
Medicare Part A (Hospital Insurance) - ...ANSWER...✓✓
one of two parts of the original Medicare program
established by Title XVIII of the Social Security Act in 1965.
It pays for hospital inpatient, skilled nursing facility,
hospice and some home health care. It's is a premium-
free benefit funded by FICA payroll deductions.
"Categorical" eligibility starts on when a U.S citizen who
paid FICA taxes for at least 40 calendar quarters turns 65.
Disabled individuals under 65 who have received Social
Security for 24 months also qualify for Medicare. Funded
by a 2.9% payroll tax.
