Navigation » List of Schools » Glendale Community College » Medical Office Administration » MOA 183 – Medical Billing and Coding » Fall 2020 » Exam 1
Below are the questions for the exam with the choices of answers:
Question #1
A FALSE
B TRUE
Question #2
A FALSE
B TRUE
Question #3
A FALSE
B TRUE
Question #4
A FALSE
B TRUE
Question #5
A Medicaid incentive payments.
B free license renewals as long as they remain in practice.
C Medicare incentive payments.
D Medicare and Medicaid incentive payments.
Question #6
A friends and family of providers.
B friends and family of patients.
C business associates of covered entities.
D corporate owners of covered entities.
Question #7
A $150,000
B $250,000
C $100,000
D $400,000
Question #8
A technical, training, and administrative.
B administrative, physical, and electronic.
C physical, administrative, and technical.
D physical, technical, and procedural.
Question #9
A claim forms.
B descriptors.
C code sets.
D modifiers.
Question #10
A 350
B 450
C 400
D 500
Question #11
A insurance carriers whose claims were affected.
B Consumer Protection Agency.
C Centers for Medicare and Medicaid Services (CMS).
D individuals whose records were affected.
Question #12
A at least 10 free copies.
B file a complaint about how long it takes to get a claim paid.
C request corrections of any inaccuracies in the records.
D designate a specific person at an insurance company who may also have access.
Question #13
A All of these
B An organ procurement organization requests it to facilitate the donation and transplantation of organs.
C A coroner requests it to assist in identifying a body.
D The U.S. Food and Drug Administration requests it in relation to a product recall.
Question #14
A designation of beneficiary form.
B acknowledgment of informed consent form.
C designation for release of medical information form.
D assignment of benefits form.
Question #15
A claim status requests and reports
B health insurance claims
C eligibility requests and verifications
D All of these
Question #16
A TRUE
B FALSE
Question #17
A FALSE
B TRUE
Question #18
A TRUE
B FALSE
Question #19
A FALSE
B TRUE
Question #20
A FALSE
B TRUE
Question #21
A FALSE
B TRUE
Question #22
A 21
B 19
C 25
D 26
Question #23
A MCOs have all asked to be accredited, but some do not qualify.
B MCOs must be accredited to operate.
C accredited MCOs are always better than nonaccredited MCOs.
D some MCOs are accredited, and some are not.
Question #24
A workplace environment.
B All of these.
C medical credentials.
D service fees.
Question #25
A actuaries.
B managers.
C accountants.
D physicians.
Question #26
A see as many patients each day as possible, even if this means less time with each patient.
B make frequent referrals to contracted network specialists.
C expand office hours and/or staff to permit more patients to be seen each day.
D treat the patient as much as possible without a specialist referral unless absolutely necessary.
Question #27
A take legal action against the MCO.
B bill the patient directly.
C charge the usual and customary fee instead of the discounted fee.
D terminate the MCO contract after filing a written notice of intention.
Question #28
A discounted per-diem rate.
B per-member-per-month rate.
C reduced per-case rate.
D reduced percentage of usual and customary charges.
Question #29
A description of how the physician will be paid for services.
B list of physicians in the network.
C description of what types of employer groups are offered coverage.
D list of patients covered by the plan.
Question #30
A participating provider.
B MCO provider.
C active provider.
D permanent provider.
Question #31
A attorney.
B physician or upper management.
C account manager or business manager.
D medical office specialist.
Question #32
A long-term care insurance.
B special risk insurance.
C major medical insurance.
D short-term health insurance.
Question #33
A employees and spouses only
B employees and children only.
C employees only.
D employees and all their dependents.
Question #34
A surgery centers.
B nursing homes.
C All of these.
D laboratories.
Question #35
A payment by capitation.
B a flexible benefit design.
C gatekeepers.
D a limited provider network.
Question #36
A Providers strive to improve the quality of their care.
B Data is collected and analyzed to measure health outcomes.
C Hospitals and physicians provide services more efficiently.
D Physicians run the risk of unfavorable evaluations by enrollees.
Question #37
A Members must obtain referrals to see a specialist.
B The plan is more restrictive than a health maintenance organization (HMO).
C Members select a primary care physician (PCP) as a gatekeeper.
D It includes a contracted network of providers.
Question #38
A It requires people to prove citizenship before receiving services.
B It cannot deny coverage due to a pre-existing condition.
C It offers five different types of government plans.
D It is also known as Obamacare.
Question #39
A individual practice association.
B open access model.
C preferred provider model.
D group model.
Question #40
A enroll more members in the health plan.
B maintain their income.
C minimize malpractice suits.
D deliver MCO-required preventive care.
Question #41
A expenses must have incurred during the coverage period.
B participation ends upon termination of employment.
C the funds cannot be used for dental and vision care.
D unused reimbursements cannot be accessed.
Question #42
A patient or carrier.
B employer or policyholder.
C policyholder or member.
D member or provider.
Question #43
A All of these.
B acting as a gatekeeper to services.
C coordinating patient care.
D referring patients to specialists.
Question #44
A dermatologist.
B family practitioner.
C internal medicine doctor.
D general practitioner.
Question #45
A billed amount.
B diagnostic code.
C allowed amount.
D adjusted amount.
Question #46
A prohibiting the use of out-of-network providers.
B discounted fees for services and mandatory high deductibles across all health plans.
C provider networks and discounted fees for services.
D provider networks and regular premium increases.
Question #47
A increased employee premium contributions.
B decreased the number of health plans available to employees.
C hired younger employees.
D refused to extend health insurance to employees.