My AAPC CPB - Chapter 12 Review Questions & Answers
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My AAPC CPB -
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My AAPC CPB -
The term for the set payment that the member pays to the healthcare provider on the day of service is the:
a. office visit fee.
b. co-insurance.
c. copay.
d. co-signer. - ANSWERSc. copay.
Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance coverag...
My AAPC CPB - Chapter 12 Review
Questions & Answers
The term for the set payment that the member pays to the healthcare provider on the
day of service is the:
a. office visit fee.
b. co-insurance.
c. copay.
d. co-signer. - ANSWERSc. copay.
Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare
insurance coverage as the:
a. Member
b. Group
c. Subscriber
d. Payer - ANSWERSc. Subscriber
What information can be found on the Blue Cross/Blue Shield insurance identification
card?
I. Type of plan
II. Subscriber's address and phone number
III. ID number
IV. Group number
V. Name of primary care provider
VI. Phone number for Member Services/Benefits questions
VII. Mailing address of BC/BS office
a. II, V, VII
b. I, III, IV, VI
c. V, VI, VII
d. I, III, IV, VI, VII - ANSWERSd. I, III, IV, VI, VII
The Blue Cross/Blue Shield member's insurance card will list which of the following:
a. provider's name.
b. type of insurance.
c. type of plan.
d. both b & c. - ANSWERSd. both b & c.
The document reporting the benefits applied to a Blue Cross/Blue Shield claim is the:
, a. Explanation of Payment (EOP).
b. Explanation of Benefits (EOB).
c. Explanation of Coverage (EOC).
d. None of the above. - ANSWERSb. Explanation of Benefits (EOB).
Blue Cross and Blue Shield is the:
a. oldest and smallest family of health benefits companies in the United States.
b. newest and largest family of health benefits companies in the United States.
c. oldest and largest family of health benefits companies in the United States.
d. only health insurance company promoting preferred provider organizations. -
ANSWERSc. oldest and largest family of health benefits companies in the United
States.
Blue Cross/Blue Shield offers which type of Medicare plan?
a. Medicare Plus
b. Medicare Advantage
c. Medicare Part G
d. Medicare Add-on - ANSWERSb. Medicare Advantage
Developing a strong relationship with the insurance Provider Representative will result
in:
a. difficulty resolving claim payment issues.
b. problems with provider credentialing.
c. increased ability to resolve billing, contracting issues that may arise.
d. both a & b. - ANSWERSc. increased ability to resolve billing, contracting issues that
may arise.
A Blue Cross/Blue Shield insurance plan that allows members to choose any provider,
but offers higher levels of coverage when members obtain services from network
providers would be an example of:
a. Health Maintenance Organization (HMO)
b. Point of Service (POS)
c. Preferred Provider Organization (PPO)
d. Indemnity - ANSWERSc. Preferred Provider Organization (PPO)
Tony's Blue Cross/Blue Shield healthcare insurance policy states that he must seek
healthcare services only from providers that are part of a specific network. What type of
Blue Cross/Blue Shield plan does Tony have?
a. POS
b. HMO
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