CPB PRACTICE EXAM B QUESTIONS AND ANSWERS
What is the term for the total amount of covered medical expenses a policyholder must pay each year
out-of-pocket before the health insurance company begins to pay any benefits?
A. Copayment
B. Deductible
C. Secondary Payment
D. Coinsurance - ANSWER-B...
A. Dr. Wallace can keep the $2,000 profit under the terms of the capitated plan.
B. Dr. Wallace experienced a loss under the capitated plan and will need to pay $2,000 to the health
plan.
C. Dr. Wallace will need to payout the $2,000 to the 175 enrollees.
D. Dr. Wallace is required to put the $2,000 in a mutual fund. - ANSWER✔✔-A. Dr. Wallace can keep the
$2,000 profit under the terms of the capitated plan.
What is the deadline for filing a Medicare claim?
A. One year from the date of service
B. 30 days from the date of service
C. 90 days from the date of service
D. Two years from the date of service - ANSWER✔✔-A. One year from the date of service
What organization is responsible in evaluating the medical necessity, appropriateness, and efficiency of
the use of healthcare services and procedures?
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