Health Insurance Billing Final Exam Review Multiple Choice Questions and
Answers 100% Accurate.
1. The coding system used to report outpatient and a. CPT
physician office procedures and services is:
a. CPT
b. SNOMED CT
c. ICD-10-PCS
d. CMIT
2. The person who prepares and reviews claims for ac- a. health insur-
curacy to ensure prompt payment is the: ance specialist
a. health insurance specialist
b. physician
c. health care provider
d. nurse
3. Ethics are: b. principles of
right or good con-
a. laws and statutes duct
b. principles of right or good conduct
c. regulations
d. conventions
4. A person who performs services for another under an b. independent
expressed or implied agreement is called a(n): contractor
a. manager
b. independent contractor
c. executive
d. employee
5. Which must usually be received from a payer before c. prior approval
treatment by a specialist will be covered?
a. sanction
b. remittance advice
c. prior approval
d. explanation of benefits
, Health Insurance Billing Final Exam Review Multiple Choice Questions and
Answers 100% Accurate.
6. Which is employed by a third-party payer and reviews b. claims examiner
health-related claims to determine whether charges
are reasonable and medically necessary?
a. health care provider
b. claims examiner
c. medical assistant
d. health insurance specialist
7. Which coding system is used to report diseases, in- a. ICD-10-CM
juries, and other reasons for inpatient and outpatient
encounters at a physician's office?
a. ICD-10-CM
b. CPT
c. HCPCS level II
d. ICD-10-PCS
8. Which is a professional member of the health care b. health care
team who provides services or supplies to the in- provider
sured?
a. third-party payer
b. health care provider
c. health insurance specialist
d. patient
9. Which manages patient health information and med- b. health informa-
ical records, administers computer information sys- tion technician
tems, and codes diagnoses and procedures for
health care services provided to patients?
a. health insurance specialist
b. health information technician
c. health care provider
d. claims examiner
10. Which is sent by the third-party payer to the patient d. explanation of
and details the results of processing a claim? benefits
a. appeal letter
b. remittance advice
c. premium statement
d. explanation of benefits
, Health Insurance Billing Final Exam Review Multiple Choice Questions and
Answers 100% Accurate.
11. Which term means the patient is not responsible for c. hold harmless
paying for what the insurance plan denies? clause
a. payment event
b. patient coverage
c. hold harmless clause
d. remittance advice
12. Which document communicates to the payer that the d. health insur-
provider is requesting reimbursement? ance claim
a. appeals letter
b. explanation of benefits
c. ledger card
d. health insurance claim
13. Which is a professional association that was founded b. AAPC
to elevate the standards of medical coding by provid-
ing certification, ongoing education, networking, and
recognition for coders?
a. AMA
b. AAPC
c. DHHS
d. CMS
14. Which professional association was founded to im- b. American
prove the quality of medical records and current ad- Health Information
vances toward an electronic and global environment, Management As-
such as the implementation of ICD-10-CM? sociation (AHIMA)
a. Centers for Medicare and Medicaid Services (CMS)
b. American Health Information Management Associ-
ation (AHIMA)
c. American Academy of Professional Coders (AAPC)
d. American Medical Association (AMA)
15. Which is a legal term that indicates the provider's a. respondeat su-
responsibility for their employee's actions and omis- perior
sions?
a. respondeat superior
b. liability
c. charitable immunity
d. hold harmless
, Health Insurance Billing Final Exam Review Multiple Choice Questions and
Answers 100% Accurate.
16. Which is an insurance agreement that protects busi- a. business liability
ness assets and covers the cost of lawsuits resulting insurance
from bodily injury, personal injury, and false advertis-
ing?
a. business liability insurance
b. professional liability insurance
c. medical malpractice insurance
d. bonding insurance
17. Which coding system is currently published by the b. HCPCS level II
Centers for Medicare and Medicaid Services (CMS)
and includes five-digit alphanumeric codes for ser-
vices, procedures, and supplies that are not classi-
fied in the CPT?
a. HCPCS Level III
b. HCPCS level II
c. CPT
d. ICD-10-PCS
18. It is important to remain current regarding news re- b. Centers for
leased from which administrative agency? Medicare and
a. American Medical Billing Association (AMBA) Medicaid Services
b. Centers for Medicare and Medicaid Services (CMS) (CMS)
c. National Electronic Billers Alliance (NEBA)
d. Department of Health and Human Services (DHHS)
19. Which is a notice that is sent by the insurance com- c. remittance ad-
pany to a provider that contains payment information vice
about a claim?
a. claims submission
b. CMS update
c. remittance advice
d. explanation of benefits
20. The process of assigning numeric and alphanumeric a. coding
characters to diagnoses, procedures, and services is
called:
a. coding
b. electronic data interchange
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