#1
What does the term 'co-payment' refer to in healthcare billing?
The total cost of a medical procedure
A fixed amount paid by the patient for a covered service
The amount the insurance company pays for a claim
A fee charged by the hospital for using their facilities
#2
In healthcare billing, what is the purpose of a 'deductible'?
The amount the insured individual must pay before the insurance coverage kicks in
A fee charged by the healthcare provider for each visit
The maximum limit on the insurance coverage
A fixed percentage of the medical bill that the patient must pay
#3
What does 'U&C' stand for in the context of healthcare billing?
Underwriting and Claims
Usual and Customary
Utilization and Compliance
Urgent Care
#4
What does 'COINS' stand for in the context of health insurance?
Coinsurance
Cost of Insurance
Coordinated Insurance
Coverage of Inpatient Services
#5
What is the role of a 'claim' in the healthcare billing process?
To request reimbursement from the patient
To request pre-authorization for a medical procedure
To submit a request for payment to the insurance company
To bill the patient directly
#6
What does 'EOB' stand for in healthcare billing and insurance?
End of Billing
Explanation of Benefits
Estimated Out-of-pocket Balance
Exceptional Order of Billing
#7
What does 'CMS-1500' refer to in healthcare billing?
A form used for submitting paper claims by healthcare professionals
A diagnostic code for mental health disorders
A billing software used by insurance companies
A federal health insurance program for seniors
#8
What is the purpose of a 'precertification' in the context of healthcare insurance?
To certify the authenticity of medical degrees
To certify eligibility for government assistance programs
To obtain approval from the insurance company before certain medical procedures
To certify the accuracy of medical billing codes
#9
What is the 'birthday rule' in health insurance?
A rule that determines the coverage start date based on the policyholder's birthday
A rule that prioritizes the insurance coverage of the policyholder with the earliest birthdate in a family
A rule that sets the maximum coverage age for certain benefits
A rule that allows policyholders to celebrate their birthdays without paying insurance premiums
#10
In the context of healthcare billing, what is 'bundled payment'?
A single payment that covers multiple healthcare services or procedures
A payment plan that includes coverage for all family members
A payment made directly to the healthcare provider by the insurance company
A payment made by the patient for services not covered by insurance
#11
What is the purpose of 'ICD-10 codes' in healthcare billing?
To identify healthcare providers
To describe medical diagnoses and procedures
To calculate insurance premiums
To track patient demographic information
#12
In healthcare billing, what is a 'write-off'?
A discount offered to patients for prompt payment
A process of erasing medical debts from the records
A deduction in the amount charged by a healthcare provider that the insurance company won't pay
A fee charged for correcting billing errors
#13
What is the primary function of a 'benefit period' in health insurance?
To determine the waiting period for coverage to begin
To define the duration during which specific benefits are available
To calculate the co-insurance percentage
To identify the policyholder's primary care physician
#14
What is 'subrogation' in the context of healthcare insurance claims?
A type of insurance fraud
The process of one party, such as an insurance company, stepping into the shoes of another party for reimbursement
The act of waiving a portion of the medical bill for financial hardship
A negotiation process between healthcare providers and insurance companies
#15
What is the purpose of a 'coordination of benefits' (COB) provision in health insurance?
To coordinate appointment schedules for different healthcare services
To coordinate the benefits provided by multiple insurance policies when an individual is covered by more than one plan
To coordinate the billing process between healthcare providers and insurance companies
To coordinate the payment of premiums for different insurance policies
#16
What is a 'Medigap' policy in health insurance?
A policy that covers the cost of prescription medications
A supplemental insurance policy that helps fill gaps in coverage for expenses like copayments and deductibles
A policy that provides coverage only for medical emergencies during travel
A policy that offers additional coverage for dental and vision care