AAPC CPB - Chapter 2 Review/ Questions with Certified Solutions.
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AAPC CPB - Chapter 2 Review/ Questions with Certified Solutions. Terms like:
The 2019 Medicare deductible and co-insurance amount for outpatient services on Part B is
a. $185 per calendar year and 20% of approved amount
b. $185 per calendar year and 20% of the billed amount
c. $185 per hos...
AAPC CPB - Chapter 2 Review/ Questions with
Certified Solutions.
The 2019 Medicare deductible and co-insurance amount for outpatient services on Part B is
a. $185 per calendar year and 20% of approved amount
b. $185 per calendar year and 20% of the billed amount
c. $185 per hospitalization and 20% of approved amount
d. $185 per calendar year - Answer: a. $185 per calendar year and 20% of approved amount
A group contracts with a third-party administrator to manage paperwork. This group pays for
the operation of the insurance plan and the costs of administration. What type of plan does this
represent?
a. Fully Insured Employer Group
b. Self - Funded ERISA
c. Association Group
d. Management Service Organization - Answer: b. Self - Funded ERISA
Page 1 of 9
, Which of the following statements is true regarding the key provisions of coverage under the
Affordable Care Act (ACA)?
a. Children under the age of 21 may be eligible to be covered under their parent's health plan if
they are in college.
b. There are 30 covered preventive services for women.
c. Patients have the right to appeal a health plan's decision to deny payment for a claim or
termination of health coverage.
d. Lifetime limits are not banned on any health plans issued. - Answer: c. Patients have the right
to appeal a health plan's decision to deny payment for a claim or termination of health
coverage.
Which type of HMO contracts with multiple specialty groups, individual practice groups, and
individual physicians?
a. Group Model HMO
b. Mixed Model HMO
c. Network Model HMO
d. Hybrid Model HMO - Answer: c. Network Model HMO
A new physician comes into the practice that is just out of medical school. He will need to be
able to see patients in the office and at the hospital. What process will he need to undergo in
order to be able to participate with Medicare and other health plans?
a. Credentialing
b. Privileging
c. Contract negotiations
d. Board certification - Answer: a. Credentialing
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