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Medical Insurance and Coding Questions and
Answers 2026 Latest Update
Accounts Payable (AP) Ans: The practice's operating expenses,
such as for overhead, salaries, supplies, and insurance.
Accounts Receivable (AR) Ans: Monies owed to a medical practice
by its patients and third-party payers.
Adjudication Ans: The process followed by health plans to
examine claims and determine benefits.
Benefits Ans: The amount of money a health plan pays for services
covered in an insurance policy.
Capitation Ans: Payment method in which a fixed prepayment
covers the provider's services to a plan member for a specified
period of time.
Cash Flow Ans: The movement of monies into or out of a business.
Certification Ans: The recognition of a person demonstrating a
superior level of skill on a national test by an official organization.
Coinsurance Ans: The portion of charges that an insured person
must pay for healthcare services after payment of the deductible
amount; usually stated as a percentage.
Compliance Ans: Actions that satisfy official guidelines and
requirements.
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Consumer-driven Health Plan (CDHP) Ans: Type of medical
insurance that combines a high-deductible health plan with a
medical savings plan that covers some out-of-pocket expenses.
Copayment Ans: An amount that a health plan requires a
beneficiary to pay at the time of service for each healthcare
encounter.
Covered Services Ans: Medical procedures and treatments that are
included as benefits under an insured's health plan.
Deductible Ans: An amount that an insured person must pay,
usually on an annual basis, for healthcare services before a health
plan's payment begins.
Diagnosis Code Ans: The number assigned to a diagnosis in the
International Classification of Diseases.
Electronic Health Record (EHR) Ans: A computerized lifelong
healthcare record for an individual that incorporates data from all
sources that provide treatment for the individual.
Ethics Ans: For a medical insurance specialist, the quality of
always acting for the good of the public and the medical practice
being served. This includes acting with honor and integrity, being
motivated to do one's best, and maintaining a professional image.
Etiquette Ans: Standards of professional behavior.
Excluded Services Ans: A service specified in a medical insurance
contract as not covered.
Fee-for-service Ans: A payment method based on provider charges.
© 2025 All rights reserved
Medical Insurance and Coding Questions and
Answers 2026 Latest Update
Accounts Payable (AP) Ans: The practice's operating expenses,
such as for overhead, salaries, supplies, and insurance.
Accounts Receivable (AR) Ans: Monies owed to a medical practice
by its patients and third-party payers.
Adjudication Ans: The process followed by health plans to
examine claims and determine benefits.
Benefits Ans: The amount of money a health plan pays for services
covered in an insurance policy.
Capitation Ans: Payment method in which a fixed prepayment
covers the provider's services to a plan member for a specified
period of time.
Cash Flow Ans: The movement of monies into or out of a business.
Certification Ans: The recognition of a person demonstrating a
superior level of skill on a national test by an official organization.
Coinsurance Ans: The portion of charges that an insured person
must pay for healthcare services after payment of the deductible
amount; usually stated as a percentage.
Compliance Ans: Actions that satisfy official guidelines and
requirements.
© 2025 All rights reserved
, 2 | Page
Consumer-driven Health Plan (CDHP) Ans: Type of medical
insurance that combines a high-deductible health plan with a
medical savings plan that covers some out-of-pocket expenses.
Copayment Ans: An amount that a health plan requires a
beneficiary to pay at the time of service for each healthcare
encounter.
Covered Services Ans: Medical procedures and treatments that are
included as benefits under an insured's health plan.
Deductible Ans: An amount that an insured person must pay,
usually on an annual basis, for healthcare services before a health
plan's payment begins.
Diagnosis Code Ans: The number assigned to a diagnosis in the
International Classification of Diseases.
Electronic Health Record (EHR) Ans: A computerized lifelong
healthcare record for an individual that incorporates data from all
sources that provide treatment for the individual.
Ethics Ans: For a medical insurance specialist, the quality of
always acting for the good of the public and the medical practice
being served. This includes acting with honor and integrity, being
motivated to do one's best, and maintaining a professional image.
Etiquette Ans: Standards of professional behavior.
Excluded Services Ans: A service specified in a medical insurance
contract as not covered.
Fee-for-service Ans: A payment method based on provider charges.
© 2025 All rights reserved
