A patient presents to be seen in the office. He does not pay at the time the services are rendered as the provider is his primary care provider, or gatekeeper. The large group practice has 800 covered members under this plan as is paid on a monthly basis with a set amount that is based on the numbe...
AAPC CPB - Chapter 2 QAS 100%
Updated!!
A patient presents to be seen in the office. He does not pay at the time the services are
rendered as the provider is his primary care provider, or gatekeeper. The large group
practice has 800 covered members under this plan as is paid on a monthly basis with a
set amount that is based on the number of members covered and their ages. What type
of plan is this?
a. PPO
b. Capitation
c. Fee-for-service
d. Indemnity - ANSWERSb. Capitation
Which insurance is a healthcare benefit program for military personnel in all seven
uniformed branches?
a. Medicare
b. Medicaid
c. TRICARE
d. BCBS - ANSWERSc. TRICARE
This type of insurance is paid for by employers for employees and takes advantage of
purchasing power of having large member numbers.
a. Individual health plan
b. Group health plan
c. Medicare
d. Medicaid - ANSWERSb. Group health plan
A family practitioner sees a Medicare patient and bills a 99213. This provider has opted-
out of Medicare. His fee for the service is $125.00. Medicare's approved amount is
$73.08, and the patient has met $0 of his deductible. What can the provider bill the
patient?
a. $125.00
b. $73.08
c. $14.62
d. $58.46 - ANSWERSa. $125.00
Why must a provider obtain an NPI number?
I. To submit claims
II. To prove that he is licensed
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