#1
Which healthcare payment system is based on a fixed amount for each service provided?
Fee-for-Service (FFS)
Capitation
Bundled Payment
Value-Based Payment
#2
What is the primary purpose of a Health Savings Account (HSA) in the context of healthcare finance?
To provide free healthcare services
To accumulate tax-free funds for medical expenses
To offer discounted insurance premiums
To facilitate direct payment to healthcare providers
#3
In healthcare billing, what is a 'UB-04' form used for?
Prescription drug coverage
Hospital inpatient and outpatient billing
Primary care physician referrals
Dental services claims
#4
What is a 'payer' in the context of healthcare payment systems?
Healthcare provider
Patient
Entity responsible for reimbursing healthcare expenses
Government agency regulating healthcare
#5
What is the role of a Health Information Management (HIM) professional in healthcare billing?
To administer vaccines
To manage patient medical records and ensure accurate coding
To perform surgical procedures
To conduct insurance sales
#6
What does the term 'ICD-10' refer to in healthcare billing and coding?
International Classification of Diseases, 10th Edition
Integrated Coding Database
Insurance Claim Data
Inpatient Care Documentation
#7
In insurance billing, what is a 'copayment'?
The total amount an insured person pays for covered healthcare services
A fixed amount paid by the patient for a covered healthcare service
The percentage of covered healthcare costs paid by the insured person
The amount a patient must pay before the insurance plan starts covering the costs
#8
In the context of healthcare reimbursement, what does the term 'RBRVS' stand for?
Resource-Based Relative Value Scale
Revised Billing and Reimbursement Verification System
Regulated Benefit Review and Validation System
Risk-Based Revenue Verification Service
#9
What is the role of a Claims Adjudicator in the insurance billing process?
To create medical claims
To assess the validity of claims and determine payment
To market insurance plans to potential clients
To negotiate reimbursement rates with healthcare providers
#10
What is the purpose of a Explanation of Benefits (EOB) statement in insurance billing?
To provide a summary of covered medical services
To explain the reasons for claim denial
To list out-of-pocket expenses for the insured
To verify patient demographics
#11
In the context of healthcare reimbursement, what does 'DR' stand for in the Medicare system?
Diagnosis Referral
Durable Resource
Diagnostic Related
Designated Recipient
#12
What is the purpose of the CPT (Current Procedural Terminology) codes in healthcare billing?
To identify medical diagnoses
To describe medical procedures and services
To determine insurance eligibility
To assess patient demographics
#13
In healthcare, what does the term 'DRG' stand for?
Diagnosis Related Group
Document Review Guidelines
Durable Resource Grants
Disease Risk Assessment
#14
Which federal program provides health coverage for individuals aged 65 and older?
Medicaid
CHIP (Children's Health Insurance Program)
Medicare
Affordable Care Act (ACA)
#15
What is the purpose of the National Provider Identifier (NPI) in healthcare billing?
To track patient medical history
To identify healthcare providers uniquely
To calculate insurance premiums
To determine patient eligibility for coverage
#16
What is the purpose of a Clearinghouse in the healthcare billing process?
To provide medical treatment
To verify patient insurance eligibility
To process and submit electronic claims to payers
To issue Explanation of Benefits (EOB) statements
#17
Which federal agency administers the Medicaid program in the United States?
Centers for Medicare & Medicaid Services (CMS)
Food and Drug Administration (FDA)
Department of Health and Human Services (HHS)
Social Security Administration (SSA)