obtained from the
A. ledger card.
B. medical treatment record.
C. confidential patient information record.
D. fee schedule.
2. If a patient is covered by Medicaid, what should you put in Block #9a?
B. The 12-digit Medicaid number
C. The policy number of other coverage, if any
D. The patient’s social security number
Lessons 2 and 3
Insurance Form Preparation
When you feel confident that you have mastered the material in Lessons 2 and 3, go to http://www.takeexamsonline.com and submit your answers online. If you don’t have access to the Internet, you can phone in or mail in your exam. If you’re unable to take the exam by telephone or online, please call Student Services and request the special answer sheet and mail in your exam. Submit your answers for this examination as soon as you complete it. Do not wait until another examination is ready.
Questions 1–45: Select the one best answer to each question. EXAMINATION NUMBER:
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3. If both nondivorced parents of a dependent child have insurance that will cover the child, which policy is considered to be the primary carrier for the child? A. The mother’s insurance
B. The father’s insurance
C. The coverage that has been in effect longer
D. The coverage of the parent whose birthday falls earlier in the year 4. As an employee at Medical & Dental Associates, how much should you charge for comprehensive service for an established patient?
A. $48 C. $72
B. $55 D. $90
5. A type of insurance that was designed to meet the needs of senior citizens is A. Medicare. C. CHAMPUS.
B. Medicaid. D. SSI.
6. CHAMPVA would be considered a primary payer for a patient who has _______ coverage. A. Medicaid C. Medicare
B. fee-for-service D. SSI
7. You should record payments that are received from insurance companies on the A. confidential patient information record.
B. medical treatment record.
C. routing slip.
D. ledger card.
8. When filling out a CMS-1500 form, where would you place the address of the agency to which you’re submitting the form?
A. At the very top right of the form C. In Block #5
B. On the EOB D. In Block #9d
9. Suppose that your office has submitted a claim for $800 to Medicare. The amount approved by Medicare for this claim is $625. How much will your office actually receive from Medicare?
A. $175 C. $625
B. $500 D. $800
10. When should you submit a claim to a secondary insurance company? A. When a primary insurance company returns a claim for correction B. When the patient authorizes you to do so
C. At the same time you submit the claim to the primary carrier D. After you receive payment from the primary insurance company 11. If the patient in Question 9 has only Medicare coverage, your office will have to bill the patient for the amount of
A. $125. C. $300.
B. $175. D. $625.
12. When you’re completing a CMS-1500 form for a fee-for-service insurance company, you should omit the patient’s telephone number because
A. a patient’s phone number is confidential information.
B. the insurance company will already have the patient’s number. C. the insurance company shouldn’t contact the patient directly by phone. D. the phone number creates problems for scanners.
13. Most of the laws that govern Medicaid coverage are set by A. the CMS. C. state governments.
B. WHO. D. the federal government.
14. The purpose of Coordination of Benefits clauses is to
A. avoid overpayments of insurance claims.
B. make the completion of the CMS-1500 easier.
C. outline the order in which insurance companies are to be billed. D. make sure that physicians receive 100 percent of what they charge. 15. One of the physicians in your office is treating Karen Roberts for a work-related injury. Karen will be...