BCBS TEST Exam Questions With Correct
Answers.
Which plan is primary? When a patient is covered by her employer-sponsored group plan and by
a government plan (not affiliated with the employer). - answerEmployer-sponsored plan
Which plan is primary? When a patient is covered by her employer's gr...
Which plan is primary? When a patient is covered by her employer-sponsored group plan and by
a government plan (not affiliated with the employer). - answer✔✔Employer-sponsored plan
Which plan is primary? When a patient is covered by her employer's group insurance plan and
also, covered by her spouse's group plan. - answer✔✔Employer-sponsored plan
For treatment not covered by the insurance plan requires prospective authorization, otherwise
known as ...? - answer✔✔Precertification
101, 102, 103 and 104 are the four Federal enrollment options and considered what ID number
on BCBS Claims? - answer✔✔Group ID number
Blue Cross and Blue Shield plans originated as two separate entities selling what type of health
plans? - answer✔✔Pre-paid Medical
Where did the first Blue Shield plan originate? - answer✔✔Palo Alto, California
What are special contract clauses that stipulate additional coverage for health care services? -
answer✔✔Riders
Most BCBS plans policyholders are known as? - answer✔✔Members
What is the deadline for submitting, customarily? - answer✔✔One year from date of service
What clause always coverage for immediate treatment sought and received for sudden, severe,
and unexpected conditions that, if left untreated, would place the patient's health in jeopardy? -
answer✔✔Medical Emergency Care Rider
Hospitalization, laboratory services, x-ray services, surgical fees, assistant surgeon fees, obstetric
care, intensive care, newborn care and chemotherapy are routine service covered by? -
answer✔✔BCBS
What year did the American Hospital Association (AHA) become the approving agency for
accreditation of new prepaid hospitalization plans? - answer✔✔1939
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