NHA CBCS Module 2: Insurance
Eligibility and Other Payer Requirements
1.
2. A child's parents have fitness coverage on the child, and there is a court docket order
declaring the father is liable for the child's fitness care. According to the birthday rule,
whose insurance might be primary?
3. A) Father
4. B) Mother - ANS-A) Father
5.
6. The father's health insurance is number one in line with court order, and the mom's
health insurance might be secondary.
7. A affected person falls off ladder even as at paintings. What kind of insurance
corresponds to the state of affairs?
8. A) Homeowners coverage
9. B) Medical fitness plan
10. C) Workers' Compensation
11. D) Auto coverage - ANS-C) Workers' Compensation
12.
13. Workers' Compensation covers an employee who is injured on the job.
14. A affected person falls off roof whilst setting up vacation lighting. What sort of insurance
corresponds to the situation?
15. A) Auto insurance
16. B) Homeowners coverage
17. C) Workers' Compensation
18. D) Medical fitness plan - ANS-B) Homeowners insurance
19.
20. Homeowners coverage covers incidents on personal property.
21. A affected person is involved in a multi-car coincidence. What kind of coverage
corresponds to the state of affairs?
22. A) Workers' Compensation
23. B) Auto coverage
24. C) Medical health plan
25. D) Homeowners insurance - ANS-B) Auto coverage
26.
27. Auto insurance covers the driving force and/or passengers in car accidents.
28. A patient gives to the number one care workplace for a cough. What form of insurance
corresponds to the state of affairs?
29. A) Medical health plan
30. B) Workers' Compensation
, 31. C) Auto coverage
32. D) Homeowners insurance - ANS-A) Medical fitness plan
33.
34. Medical fitness plans cowl an person's medical charges.
35. A affected person receives a gastric bypass surgical treatment in March, and the yearly
deductible has been met by way of this declare. After the process, the maximum
out-of-pocket quantity has also been met for the year. The affected person gives to the
workplace in June for joint injection that expenses $2000. If the coinsurance amount is
20%, which of the subsequent amounts is the patient's obligation?
36. A) $zero
37. B) $400
38. C) $1,six hundred
39. D) $2,400 - ANS-A) $zero
40.
41. Because the out-of-pocket most has been met, the affected person does now not owe
anything.
42. According to Medicare, a affected person who has diabetes mellitus need to get hold of
a hemoglobin A1C blood test as soon as each 3 months. More common checking out
should most effective be performed while medically vital. What modifier might be
reported if the professional does now not achieve an ABN prior to appearing the service
(modifiers indexed in HCPCS)?
43. A) -GA
44. B) -GZ
45. C) -GY
46. D) -GX - ANS-B) -GZ
47.
48. Modifier -GA is used when an ABN is signed and the declare form consists of protected
and noncovered offerings. Modifier -GZ is reported whilst an ABN was not signed and
the services are anticipated to be now not medically essential. Modifier -GY identifies a
carrier that is statutorily excluded as a Medicare advantage. Modifier -GX is used when a
voluntary ABN is assigned for a statutorily noncovered carrier.
49. Advance Beneficiary Notice of Noncoverage (ABN) - ANS-Documents (knowledgeable
consent) the beneficiary's choice about a service or technique that Medicare might not
cover. The offerings and their cost should be reviewed with the affected person previous
to signing the ABN. Signing the ABN would not suggest that Medicare won't pay for a
carrier, but just reassigns liability for it.
50. Car coverage - ANS-Protects the diver and passengers and can pay for scientific fees
and other prices (salary substitute, apartment vehicles) associated with an coincidence.
51. Birthday rule - ANS-Established via the NAIC and states:
52. -If the parents/guardians are married/living together, the caretaker with the earliest
birthday may be number one. If both caretakers have the identical birthday, the caretaker
who had the plan the longest is the primary.
53. -A court order has authority to specify the primary plan of a toddler/established whilst
both caretakers have health insurance.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Ashley96. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
