1.
What is a set annual dollar amount that the patient must pay prior to their insurance plan paying for services?
A
Copay
B
Deductible
C
Coinsurance
2.
This cost sharing is usually a percentage of the total cost of care.
A
Copay
B
Deductible
C
Coinsurance
3.
The refusal of an insurance company to honor a request to pay for services is a(n)
A
Denial
B
Referral
C
Authorization
4.
This type of commercial insurance plan is specific to a geographic area and usually requires a PCP and referrals for specialty care.
A
HMO
B
PPO
C
EPO
5.
This is a federally funded plan available for qualified people in which there are multiple parts. Participants may have one part or multiple parts depending on their needs.
A
Medicare
B
Medicaid
C
Medicare Advantage Plan
6.
When a person is injured or becomes ill due to their employment, this coverage may be available to cover the costs of care.
A
Medicaid
B
Workers' Compensation
C
Auto Insurance
7.
True or False. When an employee has commercial insurance through an employer, the employee is always responsible to pay the entire insurance premium.
A
True
B
False
C
8.
In healthcare services, the agreement between the medical insurance company and the healthcare organization is commonly referred to as...
A
a contract
B
a plan
C
a subscriber
9.
If a patient is responsible for any remaining balance after the insurance company has fully paid their portion of a claim, how is the patient typically notified of the balance?
A
a phone call
B
they aren't notified
C
a statement
10.
If a patient's coinsurance is 20% of the contracted rate, what would the patient be responsible for paying for a $300 service assuming the deducible has been met and there is no OOP max.
A
$60
B
$240
C
$70
11.
If a patient's coinsurance is 20% of the contracted rate, what would the patient be responsible for paying for a $300 service assuming there is $50 deducible remaining and there is no OOP max.
A
$50
B
$100
C
$110
12.
If a patient's coinsurance is 20% of the contracted rate, what would the patient be responsible for paying for a $300 service assuming both the deducible and OOP max has been met.
