Medical coding lesson5 exam ho7v
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School
Ashworth College *
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Course
H07V
Subject
Health Science
Date
Dec 6, 2023
Type
docx
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8
Uploaded by janet0812
Medical coding lesson5 exam ho7v
rall Grade (Highest Attempt)
85 / 100 - 85 %
stion 1
5 / 5 points
Deductibles, copay, and coinsurance are all examples of
Question options:
a)
withholdings.
b)
carryovers.
c)
cost-sharing.
d)
premiums.
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To review this content, see Chapter 9 of your textbook.
n 2
5 / 5 points
A complex healthcare system in which hospitals and healthcare professionals organize an interrelated
system of people and facilities that works together as a unit describes
Question options:
a)
systemized healthcare.
b)
preventive care.
c)
managed care.
d)
commercial insurance.
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n 3
5 / 5 points
Individuals who are members of a managed care plan are commonly referred to as
Question options:
a)
employees.
b)
subscribers.
c)
patients.
d)
enrollees.
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n 4
0 / 5 points
The payment methodology in which a provider receives payment for the entire time the patient is
treated instead of per service provided is
Question options:
a)
retrospective payment.
b)
prospective payment.
c)
fee for service.
d)
episode of care.
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n 5
5 / 5 points
A payment directly entered into the provider's bank account is an example of an
Question options:
a)
EOP.
b)
EFT.
c)
EOB.
d)
ERA.
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n 6
5 / 5 points
As of January 2010, which consultation codes are no longer recognized for Medicare Part B fee-for-
services payment?
Question options:
a)
99231–99233
b)
99241–99255
c)
99307–99310
d)
99234–99236
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n 7
0 / 5 points
A series of files that are labeled with a claim submission date is called a
Question options:
a)
claim copy.
b)
claim submission file.
c)
suspension file.
d)
chronological copy.
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n 8
5 / 5 points
Medicare Advantage plans belong to which part of Medicare?
Question options:
a)
Part C
b)
Part A
c)
Part B
d)
Part D
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n 9
5 / 5 points
The flat fee per visit that a patient must pay is their
Question options:
a)
premium.
b)
copay.
c)
deductible.
d)
coinsurance.
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n 10
5 / 5 points
An example of a gatekeeper is a/an
Question options:
a)
medical necessity reviewer.
b)
insurance-employed RN.
c)
radiologist.
d)
primary care physician.
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n 11
5 / 5 points
The amount of money a patient must pay each year before the insurance begins to cover is their
Question options:
a)
coinsurance.
b)
premium.
c)
deductible.
d)
copay.
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n 12
0 / 5 points
Which type of reimbursement model pays directly for each service provided?
Question options:
a)
Capitation
b)
Fee-for-service
c)
Inpatient Prospective Payment System
d)
Value-based purchasing
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n 13
5 / 5 points
One claim error that would cause low reimbursement is
Question options:
a)
procedures not paid.
b)
payment not received.
c)
precertification not completed.
d)
data error.
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n 14
5 / 5 points
A patient consistently has high blood pressure readings when at the doctor's office. The physician
prescribes antihypertensive medications. As a result, the patient's blood pressure becomes too low, and
they're admitted to the hospital for treatment. This is an example of a/an
Question options:
a)
complication.
b)
medical error.
c)
side effect.
d)
iatrogenic effect.
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n 15
5 / 5 points
Which of the following providers is a specialist?
Question options:
a)
Registered nurse
b)
Endocrinologist
c)
Licensed clinical social worker
d)
Primary care provider
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n 16
5 / 5 points
A log that shows all of the payments billed and paid to the insurance is a/an
Question options:
a)
suspension file.
b)
insurance claims register
c)
insurance claims file
d)
aged report.
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n 17
5 / 5 points
When a patient is sent by their PCP to a specialist for further treatment, the patient receives a
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Question options:
a)
referral.
b)
transfer of care.
c)
consultation.
d)
follow up.
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n 18
5 / 5 points
A specialty insurance that has been eliminated from regular coverage is said to be
Question options:
a)
capitated.
b)
noncovered.
c)
carved out.
d)
carryover.
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n 19
5 / 5 points
If a patient's allowed amount is $100, and the patient has a 20 percent coinsurance and $10 copay, how
much will the patient need to pay?
Question options:
a)
$40
b)
$50
c)
$10
d)
$30
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n 20
5 / 5 points
What legislation mandated that employers with more than 50 employees must provide health insurance
to their full-time workers?
Question options:
a)
FEHB
b)
HIPAA
c)
ACA
d)
COBRA