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CPB Practice Exam Questions and answers, 100% Accurate. Verified. Managed care organization were created to manage benefits and to develop participating provider networks. Managed care can now be categorized according to six models. Which model below listed below is not considered managed care...

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  • February 8, 2023
  • 17
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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  • cpb practice exam questions and answers
  • 100 accurate verified managed care organization were created to manage benefits and to develop participating provider networks managed care can now be ca

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CPB Practice Exam Questions and
answers, 100% Accurate. Verified.

Managed care organization were created to manage benefits and to develop participating provider
networks. Managed care can now be categorized according to six models. Which model below listed
below is not considered managed care?



A. Triple Option Plan (TOP)

B. Integrated Delivery System (IDS)

C. Health Maintenance Organization (HMO)

D. Value-added Network (VAN) - ✔✔-D. Value-added Network (VAN)



Medicare Part ______ helps pay for inpatient care in a hospital, skilled nursing facility, following a
hospital stay, some health care, and hospice care.



A. C

B. A

C. D

D. B - ✔✔-B. A



What type of insurance coverage offers assistance for some low-income people, particularly children
and pregnant women and is sponsored by state and federal government?



A. Medicaid

B BC/BS

C. Tricare/Champus

D. Commercial Payers - ✔✔-A. Medicaid

,What type of health insurance policy or other health benefit plan is offered to persons entitled to
Medicare benefits?



A. BC/BS

B. Medigap

C. Managed Care Plans

D. Public Health Care - ✔✔-B. Medigap



______ covers the medical expenses of individuals and groups. Premiums and benefits vary according to
the type of plan offered. Group health plans usually cost less than individual health plans.



A. Liability Insurance

B. Disability Insurance

C. Automobile Insurance

D. Commercial Insurance - ✔✔-D. Commercial Insurance



which statement is not true regarding blue cross blue shield?



A. They maintain negotiated contract with providers of care, and they possess features that distinguish
them from other commercial health insurance groups.

B. Covers losses to a third party caused by the insured or by an object owned by the insured or on the
premises owned by the insured.

C. Allow conversion from group to individual coverage.

D. Guarantees the transferability of membership from one local plan to another when a change in
residency moves a policy holder into an area served by a different BCBS corporation. - ✔✔-B. Covers
losses to a third party caused by the insured or by an object owned by the insured or on the premises
owned by the insured.



who is eligible for TRICARE healthcare?



A. Active duty members of the military and their qualified family members

, B. CHAMPUS-eligible retirees and qualified family members

C. Eligible survivors of members of the uniformed services

D. All of the above - ✔✔-D. All of the above



in workers' compensations, the ______ requires a statement from the patient describing the
circumstances and event surrounding the injury.



A. The First Report of Injury form

B. The CMS-1500 form

C. The state fiscal agent form

D. None of the above - ✔✔-A. The First Report of Injury form



Which statement is true? Federal law requires that all providers and suppliers submit claims to medicare
if they provide a medicare-covered service to a patient enrolled in medicare part B. This regulation does
not apply if the:



A. Patient is enrolled before the service was furnished

B. Patient is not enrolled in Medicare part B

C. Patient or the patient's legal representative signs an authorization for release of medical record

D. Provider opts out of the Medicare program but does offer medicare private contracting - ✔✔-B.
Patient is not enrolled in Medicare part B



Medicare Advantage Plans (Medicare Part C) __________.



A. Do not require referrals to see specialists

B. Charge higher premiums and deductibles compared to the Original Medicare Plan

C. Do not offer extra benefits, such as prescription drug coverage

D. Have networks, which means patients may have to see doctors who belong to the plan or go to
certain hospitals to get covered service - ✔✔-D. Have networks, which means patients may have to see
doctors who belong to the plan or go to certain hospitals to get covered service

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