A provider who is able to balance-bill a patient for the amount over the carrier's allowed charge is a(n):
contracted provider.
independent provider.
nonparticipating provider.
participating provider.
(
Q. 2) The amount of time it takes for the insurance carrier to process a claim is called the__________ time.
Fill in the blank with correct word.
(
Q. 3) What are the seven health plans available to individuals who are eligible for TRICARE benefits?
What will be an ideal response?
(
Q. 4) Under the Employee Retirement Income Security Act (ERISA), a carrier must respond to a claim that has been filed within 120 days.
Indicate whether this statement is true or false.
(
Q. 5) The form that allows an insurance company to make payments directly to a physician on behalf of the patient is the __________ form.
Fill in the blank with correct word.
(
Q. 6) Medicare prescription drug coverage is offered through:
Medicare Part A.
Medicare Part B.
Medicare Part D.
Medicare Advantage (MA).
(
Q. 7) What groups of people are eligible for TRICARE coverage?
What will be an ideal response?
(
Q. 8) When referring to Medicare, MSP refers to:
Medical specialty providers.
Medicare supplement plans.
Medicare secondary payer.
Medicare services and plans.
(
Q. 9) A patient's vital signs, height, and weight would be documented as subjective information in the medical record.
Indicate whether this statement is true or false.
(
Q. 10) If a denial is upheld when regulatory information was included in the original appeal, the medical office assistant should appeal to the:
carrier legal department.
carrier president.
Department of Labor.
Department of Insurance.
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