#1
What is the primary purpose of medical insurance billing?
To ensure patients receive accurate bills
To maximize revenue for healthcare providers
To verify patient eligibility for insurance coverage
To process claims for reimbursement
#2
Which of the following is NOT typically included in a medical insurance claim?
Patient's medical history
Itemized list of services provided
Diagnosis and procedure codes
Provider's personal contact information
#3
In medical billing, what does the term 'EOB' stand for?
Explanation of Benefits
Estimated Out-of-Pocket Costs
Emergency Operating Budget
Effective Outpatient Billing
#4
What is a common reason for medical insurance claims to be denied?
Lack of medical necessity
Provider's credentials
Patient's gender
Insurance company's financial status
#5
Which of the following is NOT a typical step in the medical insurance billing process?
Coding
Eligibility verification
Claim adjudication
Pharmacy dispensing
#6
What is a common consequence of improper medical coding in insurance claims?
Delayed reimbursement
Increased patient satisfaction
Decreased provider liability
Improved accuracy of medical records
#7
What is the primary purpose of a CMS-1500 form in medical billing?
To document patient demographics and insurance information
To request prior authorization for medical procedures
To report fraudulent billing practices
To authorize payment for medical services
#8
What is the role of a clearinghouse in medical claim processing?
To provide medical treatment to patients
To review and correct errors in insurance claims
To negotiate payment rates with insurance companies
To manage patient appointments and scheduling
#9
Which entity is responsible for setting medical billing and coding standards in the United States?
American Medical Association (AMA)
Centers for Medicare & Medicaid Services (CMS)
Healthcare Information and Management Systems Society (HIMSS)
American Health Information Management Association (AHIMA)
#10
What is the purpose of the CPT code set in medical billing?
To identify healthcare providers
To classify medical procedures and services
To determine patient insurance coverage
To calculate patient copayments
#11
Which department within a healthcare organization typically handles medical insurance billing and claim processing?
Human Resources
Patient Services
Information Technology
Revenue Cycle Management
#12
What is a common reason for a claim to be rejected during the initial submission?
Incorrect patient address
Missing provider signature
Incomplete insurance information
Failure to attach a medical record
#13
What is the purpose of the ICD-10-CM code set in medical billing?
To identify medical procedures performed
To classify diseases and medical conditions
To determine patient insurance eligibility
To calculate provider reimbursement rates
#14
Which federal law mandates the use of electronic transactions and code sets in healthcare?
#15
Which organization oversees the accreditation of coding education programs?
American Health Information Management Association (AHIMA)
Centers for Medicare & Medicaid Services (CMS)
American Medical Association (AMA)
Healthcare Information and Management Systems Society (HIMSS)