Health Insurance and Medical Billing Practices Quiz

COBRA provides continuation of health coverage after certain qualifying events.

Medical diagnosis is a crucial part of healthcare but is not directly involved in billing processes.

Medicare is a federal program providing health coverage for seniors aged 65 and older.

HIPAA safeguards health information privacy and ensures its portability and accountability.

Medicaid offers health coverage for low-income individuals and families.

Premium is the payment made by the policyholder to the insurance company for coverage.

Deductible is the initial amount the insured must pay before the insurance company starts covering expenses.

EOB provides a summary of services, costs, and coverage for processed healthcare claims.

Pre-authorization ensures approval before specific medical services or procedures are carried out.

Balance billing is charging patients for the remaining amount not covered by the insurance plan.

CMS-1500 form is used to submit healthcare services and procedures for reimbursement.

PPO is a network of healthcare providers offering reduced rates to insurance companies and insured individuals.

Medical Coders convert medical information into codes for accurate billing and insurance claims.

COB determines the primary payer when a patient has coverage under multiple insurance plans.

Coinsurance is a percentage of costs after the deductible, while copayment is a fixed amount paid for covered services.

Utilization review assesses the necessity and appropriateness of medical treatments and services for insurance coverage.