CH 14: HEALTH INSURANCE: Question Preview (ID: 16314)

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Medicare pays _____ of the approved medical bill amount once the deductible is satisfied
a) 20
b) 60
c) 70
d) 80

Medicaid cards are issued to recipients on a(n) ______ basis.
a) monthly
b) annual
c) biannual
d) as-needed

Physicians who treat patients under worker's compensation plans are usually required to resgister with the state Worker's Compensation Board:
a) anytime they need to file a claim
b) only once, unless they move or change the name of the medical practice
c) on an annual basis
d) every 5 years

The only practitioners that can currently bill Medicare with the hard copy CMS-1500 are businesses with:
a) less than 10 full-time employees, including physicians
b) more than 20 full-time employees, including physicians
c) less than 10 full-time employees, excluding physicians
d) more than 20 full-time employees, excluding physicians

Part ____ of Medicare is for payment of medical expenses such as office visitis and X-rays and laboratory services.
a) Part A
b) Part B
c) Part C
d) Part D

Part ____ of Medicare was created to provide coverage for both generic and brand name drugs
a) Part A
b) Part B
c) Part C
d) Part D

Blue Cross was originally set up to pay for:
a) physicians' services
b) hospital expenses
c) prescription medication
d) preventive health care

In a(n) _________ plan, patients are able to see specialists without having to obtain referrals from another physician.
a) preferred provider organization (PPO)
b) health maintenance organization (HMO)
c) independent practice association (IPA)
d) indemnity-type insurance

Because a primary care physician (PCP) in an HMO makes referrals and approves addtional care if needed, he or she is known as the:
a) gatekeeper
b) patient advocate
c) specialist
d) care manager

Which type of HMO is composed of providers who practice in their own individual offices and retain their own staff and operations?
a) staff model
b) group model
c) PPO
d) independent practice association

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