Medical Coding and Billing - Lessons 2 and 3Insurance Form Preparation -EXAM #38181803Questions 1-45: Select the one best answer to each question.
1. The information for Blocks 1-9 on the CMS-1500 can beobtained from theA. ledger card. B. medical treatment record. C. confidential patient information record. D. fee schedule.2. If a patient is covered by Medicaid, what should you put in Block #9a?A. Nothing B. The 12-digit Medicaid numberC. The policy number of other coverage, if any D. The patient's social security number
3. If both nondivorced parents of a dependent child have insurance that will cover the child, which policy is considered to be the primary carrier for the child?A. The mother's insurance B. The father's insuranceC. The coverage that has been in effect longer D. The coverage of the parent whose birthday falls earlier in the year4. As an employee at Medical & Dental Associates, how much should you charge for comprehensive service for an established patient?A. $48 C. $72 B. $55 D. $905. A type of insurance that was designed to meet the needs of senior citizens isA. Medicare. C. CHAMPUS. B. Medicaid. D. SSI.6. CHAMPVA would be considered a primary payer for a patient who has _______ coverage.A. Medicaid C. Medicare B. fee-for-service D. SSI7. You should record payments that are received from insurance companies on theA. confidential patient information record. B. medical treatment record.C. routing slip. D. ledger card.8. When filling out a CMS-1500 form, where would you place the address of the agency to which you're submitting the form?A. At the very top right of the form C. In Block #5 B. On the EOB D. In Block #9d9. Suppose that your office has submitted a claim for $800 to Medicare. The amountapproved by Medicare for this claim is $625. How much will your office actually receive from Medicare?A. $175 C. $625 B. $500 D. $80010. When should you submit a claim to a secondary insurance company?A. When a primary insurance company returns a claim for correction B. When the patient authorizes you to do so C. At the same time you submit the claim to the primary carrier D. After you receive payment from the primary insurance company
11. If the patient in Question 9 has only Medicare coverage, your office will have to bill the patient for the amount ofA. $125. C. $300. B. $175. D. $625.12. When you're completing a CMS-1500 form for a fee-for-service insurance company, you should omit the patient's telephone number becauseA. a patient's phone number is confidential information. B. the insurance company will already have the patient's number.C. the insurance company shouldn't contact the patient directly by phone. D. the phone number creates problems for scanners.13. Most of the laws that govern Medicaid coverage are set byA. the CMS. C. state governments. B. WHO. D. the federal government.14. The purpose of Coordination of Benefits clauses is toA. avoid overpayments of insurance claims. B. make the completion of the CMS-1500 easier.C. outline the order in which insurance companies are to be billed. D. make sure that physicians receive 100 percent of what they charge.15. One of the physicians in your office is treating Karen Roberts for a work-related injury. Karen will be receiving workers' compensation for her injury. Who should receive the claim for any treatment Karen receives that's not related to the work injury?A. Karen's employer B. Workers' compensationC. Medicare D. Karen's primary insurance company16. CHAMPUS was created to provide insurance coverage primarily forA. men and women on active duty in the armed forces. B. spouses and children of men and women on active duty.C. disabled veterans. D. retired veterans.17. In Block #8 of the CMS-1500 form, the box labeled "full-time student" and "part-timestudent" is used forA. patients who are dependent children of the subscriber. B. patients under the age of 18. C. patients who are at the age of majority but are still covered by their parents' insurance. D. patients who are dependent children with their own insurance coverage
18. What form should be attached to a CMS-1500 form submitted to a secondary insurance company?A. A copy of the CMS-1500 sent to the primary insurance company B. An Explanation of Benefits C. A copy of the patient's medical treatment record D. A copy of the patient's ledger card19. The type of insurance that's most often prone to abuse isA. auto liability. C. Medicare. B. workers' compensation. D. fee-for-service.20. What is a type of insurance policy outlining the benefits to be paid for each type of service normally based on the usual and customary rates (UCR) for each community?A. Disability insurance C. Fee-for-service B. SSDI D. SSI21. Which of the following blocks on the CMS-1500 must be completed for indemnity insurance?A. Block #19 C. Block #21B. Block #20 D. Block #23CAN U GO THROUGH #45
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