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HMAP 163- HEALTH INSURANCE 2025 MIDTERM QUIZ WITH CORRECT ANSWERS RATED A+
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HMAP 163- HEALTH INSURANCE 2025 MIDTERM QUIZ WITH CORRECT ANSWERS RATED A+
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HMAP 163- HEALTH INSURANCE 2025MIDTERM QUIZ WITH CORRECT ANSWERS
RATED A+
The traditional type of insurance that once covered the cost of
medical care is fast becoming extinct. Even though traditional
private insurance is fading, there are still individuals who choose
to pay high premiums so that they have the flexibility to seek
medical care from health care professionals of their choice. This
type of care is still very attractive to many individuals who want
the freedom to seek care from any provider and not worry about
whether they are remaining in their network, and is known as:
Correct Answer fee-for-service
The ______ is a method of reimbursement in which the Medicare
payment for patient services is made based on a predetermined,
fixed amount: Correct Answer prospective payment system
The standard claim form designed by the Centers for Medicare
and Medicaid Services to submit provider services for third-party
(insurance companies) payment is known as: Correct Answer
CMS-1500
The following health care model is a way of organizing primary
care that emphasizes care coordination and communication to
transform primary care into "what patients want it to be," and
leads to higher quality and lower costs and can improve patients'
and providers' experience of care: Correct Answer Patient-
Centered Medical Home (PCMH)
,Physicians who treat patients under workers' compensation plans
are usually required to register with the state Workers'
Compensation Board: Correct Answer on an annual basis
Health insurance offered by private companies to persons eligible
for Medicare benefits and specifically designed to supplement
such benefits is called: Correct Answer Medigap
When a provider does not accept assignment from Medicare, the
most that can be charged to the patient is ___ percent of the
Medicare-approved amount. Correct Answer 115
Because a primary care physician (PCP) in an HMO makes
referrals and approves additional care if needed, he or she is
known as the: Correct Answer gatekeeper
Part ___ of Medicare was created to provide coverage for both
generic and brand name drugs. Correct Answer D
In a(n) _____ plan, patients are able to see specialists without
having to obtain referrals from another physician. Correct Answer
indemnity-type insurance
Computerized accounting systems: Correct Answer automatically
update records as information
On computerized systems, credit balances are typically
highlighted in: Correct Answer red
A professional courtesy discount is an example of a(n): Correct
Answer adjustment
Computerized practice management software does not: Correct
Answer require a substantial amount of time to post procedures
to patient accounts
, Which of the following are types of information contained in the
patient's billing record (account or ledger)? Correct Answer All of
the above (charges, payments, balance due)
One of the duties of this job title may include preparing payroll
checks and paying the quarterly amounts due to government
agencies for taxes withheld. Correct Answer accountant
When using a manual method, all charges and payments made to
an individual patient's account are posted on a(n): Correct Answer
patient ledger card
Patients should be given a receipt: Correct Answer when they
make payment in any form
The process of transferring information from one record to
another is called: Correct Answer posting
Discounts must generally be authorized by the: Correct Answer
provider
Form used to withhold federal taxes Correct Answer W-4 Form
New patient Correct Answer One who has not received face-to-
face services within last 3 years.
Importance of pre certification, pre authorization, pre determine
Correct Answer Make sure we can file a claim and the physician
receives payment.
established patient Correct Answer One who has received face-
to-face services within the last 3 years
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