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CMAA Review
Test Description: CMAA Review over insurance.
Instructions: Answer all questions to get your test result.
1) If the insurance plan has a hold harmless clause, it means that the patient
A
automatically has lower out-of-pocket health care expenses.
B
is not responsible for paying what the insurance plan denies.
C
is charged for fees by the health care provider, per the EOB.
D
was required to pay any amounts that the insurance plan denies.
2) The process of reporting __________ as numeric and alphanumeric characters on the insurance claim is called coding.
A
national provider identifiers
B
health insurance claims identifiers
C
dates of service for procedures
D
diagnoses and procedures/services
3) A claims examiner employed by a third-party payer reviews health-related claims to determine whether the charges are reasonable, in addition to
A
assigning ICD-10-CM and CPT codes.
B
billing patients for copayments and coinsurance.
C
resubmitting denied claims to health care providers.
D
determining medical necessity of services/procedures.
4) Which is another name for a health insurance specialist?
A
health information specialist
B
billing specialist
C
reimbursement specialist
D
coding specialist
5) Which includes the identification of disease and the provision of care and treatment to persons who are sick, injured, or concerned about their health status?
A
medical care
B
third-party payment
C
preventive care
D
health insurance
6) Which may specifically result in the early detection of health problems, allowing less drastic and less expensive treatment options?
A
third-party payment
B
health care insurance
C
medical necessity
D
preventive examination
7) Which party signs a contract with a health insurance company and thus, owns the health insurance policy?
A
dependent
B
patient
C
policyholder
D
payer
8) Which provides health insurance coverage?
A
meaningful use
B
continuity of care
C
health insurance exchange
D
third-party payer
9) Which type of health insurance coverage is subsidized by employers and other organizations?
A
public health insurance
B
individual health insurance
C
group health insurance
D
universal health insurance
10) Which type of health insurance coverage has costs that are typically less per person and provides broader coverage?
A
individual health insurance
B
group health insurance
C
universal health insurance
D
public health insurance
*select an answer for all questions
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