Question 1

Match each type of health plan to its description.

-An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

Accepted Answer

A)  Independent practice association (IP
A)  
B)  Medicaid
C)  State disability or Unemployment Compensation Disability (UC
D)  
D)  TRICARE
E)  Workers' compensation insuranceF) CHAMPVAG) Health maintenance organization (HMO) H) Disability income insuranceI) MedicareJ) D) and I)
K) E) and H)

Question 2

An emancipated minor is

Accepted Answer

A)   a person younger than the age of 18 who lives independently.
B)   a person older than the age of 21.
C)   a person younger than the age of 16 who lives with his or her parents.
D)   a person younger than the age of 18 who does not live with his or her parents.E) A) and D)
F) B) and C)

Question 3

For Medicaid cases, there is no assignment of benefits unless the patient has other insurance in addition to Medicaid.

Accepted Answer

A) True 
 B)False

Question 4

Match each type of health plan to its description.

-The hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

Accepted Answer

A)  Independent practice association (IP
A)  
B)  Medicaid
C)  State disability or Unemployment Compensation Disability (UC
D)  
D)  TRICARE
E)  Workers' compensation insuranceF) CHAMPVAG) Health maintenance organization (HMO) H) Disability income insuranceI) MedicareJ) G) and H)
K) D) and H)

Question 5

The Patient Protection and Affordable Care Act (PPACA) will make health care available and affordable to Americans who are currently without insurance coverage.

Accepted Answer

A) True 
 B)False

Question 6

The efficient medical insurance specialist usually groups together all outstanding charges of patients who have the same type of insurance and processes these insurance claims at the same time.

Accepted Answer

A) True 
 B)False

Question 7

Basic health insurance coverage includes benefits for skilled nursing facilities.

Accepted Answer

A) True 
 B)False

Question 8

An insurance claims representative also may be known as the claims adjudicator.

Accepted Answer

A) True 
 B)False

Question 9

The act created to protect workers and their families so that they can get and maintain health insurance if they change or lose their jobs is called the

Accepted Answer

A)   Consolidated Omnibus Budget Reconciliation Act (COBR
A)  .
B)   Health Care Finance Administration Act (HCFA
A)  .
C)   Bush Fair Health Act (BFH
A)  .
D)   Health Insurance Portability and Accountability Act (HIPA
A)  .E) B) and D)
F) A) and D)

Question 10

The five classifications of health insurance policies are (1) cancelable, (2) optionally renewable, (3) conditionally renewable, (4) guaranteed renewable, and (5) ____________________.

Accepted Answer

The answer of The five classifications of health insurance policies...

Question 11

In a managed care plan, the participating provider is also referred to as: ___________________________

Accepted Answer

A preferre...

Question 12

Discovering the maximum dollar amount that the carrier will pay for a procedure is called ____________________.

Accepted Answer

The answer of Discovering the maximum dollar amount that the...

Question 13

Most legal issues of private health insurance claims fall under

Accepted Answer

A)   federal law.
B)   civil law.
C)   regional law.
D)   government laws.E) C) and D)
F) A) and D)

Question 14

The concept of managed care began in the 1930s when Montgomery Ward and Company offered it to their employees.

Accepted Answer

A) True 
 B)False

Question 15

The first legal item in the business of handling medical insurance is the insurance ____________________ or policy.

Accepted Answer

The answer of The first legal item in the business...

Question 16

Match each type of health plan to its description.

-A contract that insures a person against on-the-job injury or illness.

Accepted Answer

A)  Independent practice association (IP
A)  
B)  Medicaid
C)  State disability or Unemployment Compensation Disability (UC
D)  
D)  TRICARE
E)  Workers' compensation insuranceF) CHAMPVAG) Health maintenance organization (HMO) H) Disability income insuranceI) MedicareJ) A) and E)
K) C) and G)

Question 17

If a child has health insurance coverage from two parents, according to the birthday law

Accepted Answer

A)   the father's insurance is always primary.
B)   the mother's insurance is always primary.
C)   the health plan of the person whose birthday (month and day)  falls earlier in the calendar year will pay first.
D)   it is only in effect if the parents are divorced.E) A) and B)
F) A) and C)

Question 18

Match each type of health plan to its description.

-Government-sponsored program that provides hospital and medical services for dependents of active duty uniform service members, military retirees and their families, and survivors of uniformed services.

Accepted Answer

A)  Independent practice association (IP
A)  
B)  Medicaid
C)  State disability or Unemployment Compensation Disability (UC
D)  
D)  TRICARE
E)  Workers' compensation insuranceF) CHAMPVAG) Health maintenance organization (HMO) H) Disability income insuranceI) MedicareJ) D) and E)
K) B) and D)

Question 19

If Mary Smith goes to Dr. Baker's office and Dr. Baker gives Mary Smith professional services that she accepts, this is an expressed contract.

Accepted Answer

A) True 
 B)False

Question 20

The person who is applying for insurance coverage is called the ____________________.

Accepted Answer

The answer of The person who is applying for insurance...

Exam 3: Basics of Health Insurance

The Patient Protection and Affordable Care Act (PPACA) will make health care available and affordable to Americans who are currently without insurance coverage.

Correct AnswerverifiedShow Answer

In a managed care plan, the participating provider is also referred to as: ___________________________

Correct AnswerverifiedA preferre...View AnswerShow Answer

Most legal issues of private health insurance claims fall under

Correct AnswerverifiedShow Answer

Match each type of health plan to its description. -A contract that insures a person against on-the-job injury or illness.

Correct AnswerverifiedShow Answer

An emancipated minor is

Correct AnswerverifiedShow Answer

If Mary Smith goes to Dr. Baker's office and Dr. Baker gives Mary Smith professional services that she accepts, this is an expressed contract.

Correct AnswerverifiedShow Answer

The act created to protect workers and their families so that they can get and maintain health insurance if they change or lose their jobs is called the

Correct AnswerverifiedShow Answer

An insurance claims representative also may be known as the claims adjudicator.

Correct AnswerverifiedShow Answer

The first legal item in the business of handling medical insurance is the insurance ____________________ or policy.

Correct AnswerverifiedShow Answer

For Medicaid cases, there is no assignment of benefits unless the patient has other insurance in addition to Medicaid.

Correct AnswerverifiedShow Answer

The concept of managed care began in the 1930s when Montgomery Ward and Company offered it to their employees.

Correct AnswerverifiedShow Answer

The efficient medical insurance specialist usually groups together all outstanding charges of patients who have the same type of insurance and processes these insurance claims at the same time.

Correct AnswerverifiedShow Answer

Discovering the maximum dollar amount that the carrier will pay for a procedure is called ____________________.

Correct AnswerverifiedShow Answer

The five classifications of health insurance policies are (1) cancelable, (2) optionally renewable, (3) conditionally renewable, (4) guaranteed renewable, and (5) ____________________.

Correct AnswerverifiedShow Answer

Basic health insurance coverage includes benefits for skilled nursing facilities.

Correct AnswerverifiedShow Answer

Match each type of health plan to its description. -An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

Correct AnswerverifiedShow Answer

If a child has health insurance coverage from two parents, according to the birthday law

Correct AnswerverifiedShow Answer

Match each type of health plan to its description. -The hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

Correct AnswerverifiedShow Answer

The person who is applying for insurance coverage is called the ____________________.

Correct AnswerverifiedShow Answer

Match each type of health plan to its description. -Government-sponsored program that provides hospital and medical services for dependents of active duty uniform service members, military retirees and their families, and survivors of uniformed services.

Correct AnswerverifiedShow Answer

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