Medical Biller Exam Questions With Already Passed Answers.
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Course
Cigna
Institution
Cigna
Tricare is insurance for:
a. Active-duty military and their families
b. Surviving spouses of military service members
c. Retired service members
d. All of the above - Answer d. All of the above
Medicaid is administered by:
a. state governments
b. federal government
c. priva...
Medical Biller Exam Questions With
Already Passed Answers.
Tricare is insurance for:
a. Active-duty military and their families
b. Surviving spouses of military service members
c. Retired service members
d. All of the above - Answer d. All of the above
Medicaid is administered by:
a. state governments
b. federal government
c. private companies
d. nonprofit organizations - Answer a. state governments
Which of the following is not a private insurance carrier?
a. Cigna
b. Aetna
c. United Healthcare
d. CMS - Answer d. CMS
A patient comes in with a piece of metal shavings in his eye that he got while welding at his job. He has
Anthem health insurance through his work. Which of the following insurances would cover his visit?
a. Medicaid
b. Anthem
,c. Worker's compensation
d. Disability insurance - Answer c. Worker's compensation
The difference between an HMO and a PPO is:
a. HMOs cost less, but provide better care.
b. PPO plans allow patients to be seen out of network at an increased cost, while HMOs do not.
c. HMO plans allow patients to be seen out of network at an increased cost, while PPOs do not.
d. There is no difference between HMOs and PPOs. - Answer b. PPO plans allow patients to be seen out
of network at an increased cost, while HMOs do not.
The time allowed to submit a claim to Medicare is:
a. 365 days
b. 180 days
c. 120 days
d. 90 days - Answer a. 365 days
The amount a provider charges the insurance company for services:
a. Varies depending on how much the insurance reimburses for that procedure
b. Must be a set amount per procedure for all insurance carriers
c. Must be a set amount for each particular insurance carrier
d. Can change depending on how complex the procedure was - Answer b. Must be a set amount per
procedure for all insurance carriers
According to CMS, which form must be obtained and signed for Medicare beneficiaries receiving non-
covered services before those services are rendered?
a. CMS-1500
, b. ABB
c. NBN
d. ABN - Answer d. ABN
Marge has Medicaid and goes to see the chiropractor once a week. The chiropractor takes Medicaid but
informs Marge that she has a $25 copay for each visit. Marge's insurance card lists no copay. When
questioned, the billing office tells Marge that her insurance only reimburses $17 per chiropractic visit
and it would cost them more to bill her insurance than it would just to have her pay--and it's only $25.
According to Medicaid regulations:
a. It is illegal to bill Medicaid patients without signed consent.
b. it is illegal to bill Medicaid patients before billing Medicaid first.
c. Marge should call Medicaid to see if her copay has changed.
d. Marge should ask to pay $17 per visit. - Answer a. It is illegal to bill Medicaid patients without signed
consent.
A Medicare patient calls. She's been seeing Dr. Hamilton for 10 years for her chronic conditions. It's
January and her furnace just broke and it will be $500--and she's on a fixed income and just can't swing
the furnace and her Medicare deductible right now. She's going to have to make payments on the
furnace as it is. She wants to know if there's any way you could give her a break and waive the
deductible. How should the billing professional respond?
a. "Sorry, you cannot waive the deductible."
b. "You must come in and fill out a financial hardship form."
c. "You have to make payments, but you have 3 months to pay per company policy."
d. "I'll speak to Dr. Hamilton and see if there isn't anything that can be done to help you." - Answer b.
"You must come in and fill out a financial hardship form."
Your neighbor's 17-year-old daughter was recently admitted to the hospital where you work in the billing
department. The nurse told you that she's asleep and your neighbor is out of town, but you are curious
what treatments she's received and want to make sure that she told the provider she is allergic to latex.
What do you do?
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