#1
What does COB stand for in health insurance?
Coordination of Benefits
ExplanationDetermines primary and secondary coverage for medical expenses.
#2
Which of the following is NOT a common health insurance plan type?
ESA
ExplanationESA is not a recognized health insurance plan type.
#3
Which federal program provides health insurance for individuals aged 65 and older?
Medicare
ExplanationGovernment healthcare program for seniors.
#4
Which organization oversees the administration of Medicaid?
Centers for Medicare & Medicaid Services (CMS)
ExplanationFederal agency managing Medicaid program.
#5
What does EOB stand for in health insurance?
Explanation of Benefits
ExplanationDetailed statement explaining healthcare benefits.
#6
What is ICD-10 used for in medical billing?
Assigning diagnosis codes
ExplanationStandardizes codes for diagnoses on healthcare claims.
#7
What is the term for the amount a patient is required to pay before insurance coverage kicks in?
Deductible
ExplanationInitial amount paid by the insured before insurance coverage starts.
#8
What is the term for a healthcare provider's negotiated rate with an insurance company?
Allowed amount
ExplanationAgreed-upon rate between provider and insurer.
#9
What is a pre-authorization in health insurance?
Approval for medical treatment in advance
ExplanationRequired approval before certain medical services are covered.
#10
What is a common term for the percentage of medical costs that a patient must pay after meeting their deductible?
Coinsurance
ExplanationCost-sharing where patient pays a percentage of expenses.
#11
What is the purpose of a CMS-1500 form in medical billing?
To submit claims to insurance companies
ExplanationStandard form used for submitting healthcare claims.