Quiz 17 Earned 92.00% You have come a long way! Keep it up! If you have concerns about the way this quiz was graded, please contact your instructor so it can be manually reviewed. volume_downRead to Me Select the best answer from the choices provided. 1. volume_downRead to Me Chloe’s parents, Matt and Michelle have family insurance benefits. Matt’s birthday is July 10, 1968, and Michelle’s birthday is September 5, 1967, and they are married to each other. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Matt This was the choice you selected. You are correct.  B. Michelle  C. There’s not enough information to determine the answer. 2. volume_downRead to Me Which is a FALSE statement? Earned 4.00 of 4.000 points.  A. The father’s coverage is always primary when following the gender rule.  B. Dependent children of parents who are married fall under the birthday rule.  C. Dependents of those that are married follow the birthday or gender rule.  D. The birthday rule dictates that the parent whose birthday year falls earlier is the primary carrier. This was the choice you selected. You are correct. 3. volume_downRead to Me Stella and George have divorced, and Stella has custody of Macy; however, the court decree indicates that George is responsible for Macy’s healthcare expenses. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Stella  B. George This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 4. volume_downRead to Me Marty lives with his mother and stepfather. Marty’s mother’s health plan is with Cigna, and Marty’s father’s health plan is with Health Services. His stepfather’s health plan is with Blue Cross of Colorado. What is the order of the payer coverage? Earned 4.00 of 4.000 points.  A. 1) Blue Cross of Colorado; 2) Cigna; 3) Health Services  B. 1) Cigna; 2) Health Services; 3) Blue Cross of Colorado  C. 1) Cigna; 2) Blue Cross of Colorado; 3) Health Services This was the choice you selected. You are correct.  D. 1) Health Services; 2) Cigna; 3) Blue Cross of Colorado 5. volume_downRead to Me Which is a FALSE statement of the COB? Earned 4.00 of 4.000 points.  A. COBs eliminate duplication of payments.  B. It applies to a person who is covered under more than one health plan.  C. COBs allow patients to receive the maximum benefits entitled to them.  D. It coordinates payments for services up to 50 percent of the covered charges. This was the choice you selected. You are correct. 6. volume_downRead to Me Melissa and John are married to each other, and each have insurance coverage through their employer. Because John’s birthday is first in the calendar year, Melissa will have coverage through John’s insurance first, with her insurance as the secondary coverage. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 7. volume_downRead to Me Which rule indicates the father’s coverage is primary for all dependent children of parents not separated or divorced? Earned 4.00 of 4.000 points.  A. Gender This was the choice you selected. You are correct.  B. Birthday 8. volume_downRead to Me In the case of a divorce, which plan will pay first for the child? Earned 4.00 of 4.000 points.  A. The plan of the parent with custody This was the choice you selected. You are correct.  B. The plan of the parent who does not have custody  C. The plan of the spouse of the parent with custody 9. volume_downRead to Me If the court decree states that one parent is responsible for the healthcare expense of the child, but the other parent has better insurance, it’s okay to just switch primary carriers. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 10. volume_downRead to Me Monica’s parents, Bill and Patty are married to each other. Since both Bill and Patty have family insurance benefits, you will use the birthday rule to determine Monica’s primary and secondary policies. Patty’s birthday is March 15, 1968, and Bill’s birthday is September 25, 1967. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Bill  B. Patty This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 11. volume_downRead to Me Which is NOT one of the three primary goals of the Affordable Care Act? Earned 4.00 of 4.000 points.  A. Increasing affordability of health insurance  B. Increasing the rates for those insured already This was the choice you selected. You are correct.  C. Expanding insurance coverage  D. Reducing the costs of health care 12. volume_downRead to Me TRICARE claims should be received within _____ of the date of service. Earned 4.00 of 4.000 points.  A. 30 days  B. 60 days  C. 120 days  D. one year This was the choice you selected. You are correct. 13. volume_downRead to Me What does TRICARE use to detail how an injury occurred? Earned 4.00 of 4.000 points.  A. NAS  B. CMS-1500  C. Form CA-1  D. DD Form 2527 This was the choice you selected. You are correct. 14. volume_downRead to Me Medicare appeals must be filed _____ days from receipt of the denial. Earned 4.00 of 4.000 points.  A. 30  B. 60  C. 90  D. 120 This was the choice you selected. You are correct. 15. volume_downRead to Me You should contact the insurance commissioner _____. Earned 4.00 of 4.000 points.  A. any time a claim is denied  B. before resubmitting a claim  C. rather than filing an appeal  D. if you suspect fraudulent claims This was the choice you selected. You are correct. 16. volume_downRead to Me Which is a TRUE statement of timely filing? Earned 4.00 of 4.000 points.  A. If the claim is denied due to timely filing, you will bill the patient.  B. Claims are paid in full even if they are not filed timely.  C. Timely filing can be waived, but it’s not usually done. This was the choice you selected. You are correct. 17. volume_downRead to Me First Report of Injury is filed with all EXCEPT the _____. Earned 0.00 of 4.000 points.  A. employer of the injured worker This was the choice you selected, but it was not the correct answer.  B. worker’s medical record  C. OIG This was the correct answer. 18. volume_downRead to Me A tracer _____. Earned 4.00 of 4.000 points.  A. locates the EOB  B. explains procedures listed on the claim  C. enables insurance companies to locate missing claims This was the choice you selected. You are correct.  D. allows you to submit medical records to substantiate medical necessity 19. volume_downRead to Me The _____ must submit dates of exams and treatments to the OWCP. Earned 4.00 of 4.000 points.  A. employer  B. employee This was the choice you selected. You are correct.  C. insurance carrier 20. volume_downRead to Me In which situation should you inquire on the status of a claim? Earned 4.00 of 4.000 points.  A. You should never inquire about the status of a claim.  B. Reimbursement was received for a claim you didn’t file. This was the choice you selected. You are correct.  C. A claim is 10 days old and no reimbursement has been made.  D. A claim is 30 days old and the EOB indicates the service was applied to the deductible. 21. volume_downRead to Me For work comp, the _____ physician is the provider who first diagnosed and treated the injury. Earned 4.00 of 4.000 points.  A. primary  B. providing  C. first treating This was the choice you selected. You are correct.  D. referring volume_downRead to Me Use the claims log to select the best answer from the choices provided. Each item is worth 4 points. 22. volume_downRead to Me What is the filing date? Earned 0.00 of 4.000 points.  A. 04/01/XX This was the choice you selected, but it was not the correct answer.  B. 04/02/XX  C. 04/03/XX This was the correct answer. 23. volume_downRead to Me How much did Mountain States pay of Frank Alba’s 4/1/XX service? Earned 4.00 of 4.000 points.  A. $16.00  B. $0.00  C. $8.00  D. $76.00 This was the choice you selected. You are correct. 24. volume_downRead to Me Which patient required a second billing? Earned 4.00 of 4.000 points.  A. Frank Alba  B. Joanne Carty This was the choice you selected. You are correct.  C. Nikki Salazar  D. Mae Griggs 25. volume_downRead to Me Which patient received a refund? Earned 4.00 of 4.000 points.  A. Rob Martin This was the choice you selected. You are correct.  B. Frank Alba  C. Joanne Carty  D. Nikki Salazar bug_report Copyright © 2024 U.S. Care Quiz 17 Earned 92.00% You have come a long way! Keep it up! If you have concerns about the way this quiz was graded, please contact your instructor so it can be manually reviewed. volume_downRead to Me Select the best answer from the choices provided. 1. volume_downRead to Me Chloe’s parents, Matt and Michelle have family insurance benefits. Matt’s birthday is July 10, 1968, and Michelle’s birthday is September 5, 1967, and they are married to each other. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Matt This was the choice you selected. You are correct.  B. Michelle  C. There’s not enough information to determine the answer. 2. volume_downRead to Me Which is a FALSE statement? Earned 4.00 of 4.000 points.  A. The father’s coverage is always primary when following the gender rule.  B. Dependent children of parents who are married fall under the birthday rule.  C. Dependents of those that are married follow the birthday or gender rule.  D. The birthday rule dictates that the parent whose birthday year falls earlier is the primary carrier. This was the choice you selected. You are correct. 3. volume_downRead to Me Stella and George have divorced, and Stella has custody of Macy; however, the court decree indicates that George is responsible for Macy’s healthcare expenses. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Stella  B. George This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 4. volume_downRead to Me Marty lives with his mother and stepfather. Marty’s mother’s health plan is with Cigna, and Marty’s father’s health plan is with Health Services. His stepfather’s health plan is with Blue Cross of Colorado. What is the order of the payer coverage? Earned 4.00 of 4.000 points.  A. 1) Blue Cross of Colorado; 2) Cigna; 3) Health Services  B. 1) Cigna; 2) Health Services; 3) Blue Cross of Colorado  C. 1) Cigna; 2) Blue Cross of Colorado; 3) Health Services This was the choice you selected. You are correct.  D. 1) Health Services; 2) Cigna; 3) Blue Cross of Colorado 5. volume_downRead to Me Which is a FALSE statement of the COB? Earned 4.00 of 4.000 points.  A. COBs eliminate duplication of payments.  B. It applies to a person who is covered under more than one health plan.  C. COBs allow patients to receive the maximum benefits entitled to them.  D. It coordinates payments for services up to 50 percent of the covered charges. This was the choice you selected. You are correct. 6. volume_downRead to Me Melissa and John are married to each other, and each have insurance coverage through their employer. Because John’s birthday is first in the calendar year, Melissa will have coverage through John’s insurance first, with her insurance as the secondary coverage. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 7. volume_downRead to Me Which rule indicates the father’s coverage is primary for all dependent children of parents not separated or divorced? Earned 4.00 of 4.000 points.  A. Gender This was the choice you selected. You are correct.  B. Birthday 8. volume_downRead to Me In the case of a divorce, which plan will pay first for the child? Earned 4.00 of 4.000 points.  A. The plan of the parent with custody This was the choice you selected. You are correct.  B. The plan of the parent who does not have custody  C. The plan of the spouse of the parent with custody 9. volume_downRead to Me If the court decree states that one parent is responsible for the healthcare expense of the child, but the other parent has better insurance, it’s okay to just switch primary carriers. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 10. volume_downRead to Me Monica’s parents, Bill and Patty are married to each other. Since both Bill and Patty have family insurance benefits, you will use the birthday rule to determine Monica’s primary and secondary policies. Patty’s birthday is March 15, 1968, and Bill’s birthday is September 25, 1967. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Bill  B. Patty This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 11. volume_downRead to Me Which is NOT one of the three primary goals of the Affordable Care Act? Earned 4.00 of 4.000 points.  A. Increasing affordability of health insurance  B. Increasing the rates for those insured already This was the choice you selected. You are correct.  C. Expanding insurance coverage  D. Reducing the costs of health care 12. volume_downRead to Me TRICARE claims should be received within _____ of the date of service. Earned 4.00 of 4.000 points.  A. 30 days  B. 60 days  C. 120 days  D. one year This was the choice you selected. You are correct. 13. volume_downRead to Me What does TRICARE use to detail how an injury occurred? Earned 4.00 of 4.000 points.  A. NAS  B. CMS-1500  C. Form CA-1  D. DD Form 2527 This was the choice you selected. You are correct. 14. volume_downRead to Me Medicare appeals must be filed _____ days from receipt of the denial. Earned 4.00 of 4.000 points.  A. 30  B. 60  C. 90  D. 120 This was the choice you selected. You are correct. 15. volume_downRead to Me You should contact the insurance commissioner _____. Earned 4.00 of 4.000 points.  A. any time a claim is denied  B. before resubmitting a claim  C. rather than filing an appeal  D. if you suspect fraudulent claims This was the choice you selected. You are correct. 16. volume_downRead to Me Which is a TRUE statement of timely filing? Earned 4.00 of 4.000 points.  A. If the claim is denied due to timely filing, you will bill the patient.  B. Claims are paid in full even if they are not filed timely.  C. Timely filing can be waived, but it’s not usually done. This was the choice you selected. You are correct. 17. volume_downRead to Me First Report of Injury is filed with all EXCEPT the _____. Earned 0.00 of 4.000 points.  A. employer of the injured worker This was the choice you selected, but it was not the correct answer.  B. worker’s medical record  C. OIG This was the correct answer. 18. volume_downRead to Me A tracer _____. Earned 4.00 of 4.000 points.  A. locates the EOB  B. explains procedures listed on the claim  C. enables insurance companies to locate missing claims This was the choice you selected. You are correct.  D. allows you to submit medical records to substantiate medical necessity 19. volume_downRead to Me The _____ must submit dates of exams and treatments to the OWCP. Earned 4.00 of 4.000 points.  A. employer  B. employee This was the choice you selected. You are correct.  C. insurance carrier 20. volume_downRead to Me In which situation should you inquire on the status of a claim? Earned 4.00 of 4.000 points.  A. You should never inquire about the status of a claim.  B. Reimbursement was received for a claim you didn’t file. This was the choice you selected. You are correct.  C. A claim is 10 days old and no reimbursement has been made.  D. A claim is 30 days old and the EOB indicates the service was applied to the deductible. 21. volume_downRead to Me For work comp, the _____ physician is the provider who first diagnosed and treated the injury. Earned 4.00 of 4.000 points.  A. primary  B. providing  C. first treating This was the choice you selected. You are correct.  D. referring volume_downRead to Me Use the claims log to select the best answer from the choices provided. Each item is worth 4 points. 22. volume_downRead to Me What is the filing date? Earned 0.00 of 4.000 points.  A. 04/01/XX This was the choice you selected, but it was not the correct answer.  B. 04/02/XX  C. 04/03/XX This was the correct answer. 23. volume_downRead to Me How much did Mountain States pay of Frank Alba’s 4/1/XX service? Earned 4.00 of 4.000 points.  A. $16.00  B. $0.00  C. $8.00  D. $76.00 This was the choice you selected. You are correct. 24. volume_downRead to Me Which patient required a second billing? Earned 4.00 of 4.000 points.  A. Frank Alba  B. Joanne Carty This was the choice you selected. You are correct.  C. Nikki Salazar  D. Mae Griggs 25. volume_downRead to Me Which patient received a refund? Earned 4.00 of 4.000 points.  A. Rob Martin This was the choice you selected. You are correct.  B. Frank Alba  C. Joanne Carty  D. Nikki Salazar bug_report Copyright © 2024 U.S. Care Quiz 17 Earned 92.00% You have come a long way! Keep it up! If you have concerns about the way this quiz was graded, please contact your instructor so it can be manually reviewed. volume_downRead to Me Select the best answer from the choices provided. 1. volume_downRead to Me Chloe’s parents, Matt and Michelle have family insurance benefits. Matt’s birthday is July 10, 1968, and Michelle’s birthday is September 5, 1967, and they are married to each other. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Matt This was the choice you selected. You are correct.  B. Michelle  C. There’s not enough information to determine the answer. 2. volume_downRead to Me Which is a FALSE statement? Earned 4.00 of 4.000 points.  A. The father’s coverage is always primary when following the gender rule.  B. Dependent children of parents who are married fall under the birthday rule.  C. Dependents of those that are married follow the birthday or gender rule.  D. The birthday rule dictates that the parent whose birthday year falls earlier is the primary carrier. This was the choice you selected. You are correct. 3. volume_downRead to Me Stella and George have divorced, and Stella has custody of Macy; however, the court decree indicates that George is responsible for Macy’s healthcare expenses. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Stella  B. George This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 4. volume_downRead to Me Marty lives with his mother and stepfather. Marty’s mother’s health plan is with Cigna, and Marty’s father’s health plan is with Health Services. His stepfather’s health plan is with Blue Cross of Colorado. What is the order of the payer coverage? Earned 4.00 of 4.000 points.  A. 1) Blue Cross of Colorado; 2) Cigna; 3) Health Services  B. 1) Cigna; 2) Health Services; 3) Blue Cross of Colorado  C. 1) Cigna; 2) Blue Cross of Colorado; 3) Health Services This was the choice you selected. You are correct.  D. 1) Health Services; 2) Cigna; 3) Blue Cross of Colorado 5. volume_downRead to Me Which is a FALSE statement of the COB? Earned 4.00 of 4.000 points.  A. COBs eliminate duplication of payments.  B. It applies to a person who is covered under more than one health plan.  C. COBs allow patients to receive the maximum benefits entitled to them.  D. It coordinates payments for services up to 50 percent of the covered charges. This was the choice you selected. You are correct. 6. volume_downRead to Me Melissa and John are married to each other, and each have insurance coverage through their employer. Because John’s birthday is first in the calendar year, Melissa will have coverage through John’s insurance first, with her insurance as the secondary coverage. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 7. volume_downRead to Me Which rule indicates the father’s coverage is primary for all dependent children of parents not separated or divorced? Earned 4.00 of 4.000 points.  A. Gender This was the choice you selected. You are correct.  B. Birthday 8. volume_downRead to Me In the case of a divorce, which plan will pay first for the child? Earned 4.00 of 4.000 points.  A. The plan of the parent with custody This was the choice you selected. You are correct.  B. The plan of the parent who does not have custody  C. The plan of the spouse of the parent with custody 9. volume_downRead to Me If the court decree states that one parent is responsible for the healthcare expense of the child, but the other parent has better insurance, it’s okay to just switch primary carriers. Earned 4.00 of 4.000 points.  A. True  B. False This was the choice you selected. You are correct. 10. volume_downRead to Me Monica’s parents, Bill and Patty are married to each other. Since both Bill and Patty have family insurance benefits, you will use the birthday rule to determine Monica’s primary and secondary policies. Patty’s birthday is March 15, 1968, and Bill’s birthday is September 25, 1967. Which is the primary payer? Earned 4.00 of 4.000 points.  A. Bill  B. Patty This was the choice you selected. You are correct.  C. There’s not enough information to determine the answer. 11. volume_downRead to Me Which is NOT one of the three primary goals of the Affordable Care Act? Earned 4.00 of 4.000 points.  A. Increasing affordability of health insurance  B. Increasing the rates for those insured already This was the choice you selected. You are correct.  C. Expanding insurance coverage  D. Reducing the costs of health care 12. volume_downRead to Me TRICARE claims should be received within _____ of the date of service. Earned 4.00 of 4.000 points.  A. 30 days  B. 60 days  C. 120 days  D. one year This was the choice you selected. You are correct. 13. volume_downRead to Me What does TRICARE use to detail how an injury occurred? Earned 4.00 of 4.000 points.  A. NAS  B. CMS-1500  C. Form CA-1  D. DD Form 2527 This was the choice you selected. You are correct. 14. volume_downRead to Me Medicare appeals must be filed _____ days from receipt of the denial. Earned 4.00 of 4.000 points.  A. 30  B. 60  C. 90  D. 120 This was the choice you selected. You are correct. 15. volume_downRead to Me You should contact the insurance commissioner _____. Earned 4.00 of 4.000 points.  A. any time a claim is denied  B. before resubmitting a claim  C. rather than filing an appeal  D. if you suspect fraudulent claims This was the choice you selected. You are correct. 16. volume_downRead to Me Which is a TRUE statement of timely filing? Earned 4.00 of 4.000 points.  A. If the claim is denied due to timely filing, you will bill the patient.  B. Claims are paid in full even if they are not filed timely.  C. Timely filing can be waived, but it’s not usually done. This was the choice you selected. You are correct. 17. volume_downRead to Me First Report of Injury is filed with all EXCEPT the _____. Earned 0.00 of 4.000 points.  A. employer of the injured worker This was the choice you selected, but it was not the correct answer.  B. worker’s medical record  C. OIG This was the correct answer. 18. volume_downRead to Me A tracer _____. Earned 4.00 of 4.000 points.  A. locates the EOB  B. explains procedures listed on the claim  C. enables insurance companies to locate missing claims This was the choice you selected. You are correct.  D. allows you to submit medical records to substantiate medical necessity 19. volume_downRead to Me The _____ must submit dates of exams and treatments to the OWCP. Earned 4.00 of 4.000 points.  A. employer  B. employee This was the choice you selected. You are correct.  C. insurance carrier 20. volume_downRead to Me In which situation should you inquire on the status of a claim? Earned 4.00 of 4.000 points.  A. You should never inquire about the status of a claim.  B. Reimbursement was received for a claim you didn’t file. This was the choice you selected. You are correct.  C. A claim is 10 days old and no reimbursement has been made.  D. A claim is 30 days old and the EOB indicates the service was applied to the deductible. 21. volume_downRead to Me For work comp, the _____ physician is the provider who first diagnosed and treated the injury. Earned 4.00 of 4.000 points.  A. primary  B. providing  C. first treating This was the choice you selected. You are correct.  D. referring volume_downRead to Me Use the claims log to select the best answer from the choices provided. Each item is worth 4 points. 22. volume_downRead to Me What is the filing date? Earned 0.00 of 4.000 points.  A. 04/01/XX This was the choice you selected, but it was not the correct answer.  B. 04/02/XX  C. 04/03/XX This was the correct answer. 23. volume_downRead to Me How much did Mountain States pay of Frank Alba’s 4/1/XX service? Earned 4.00 of 4.000 points.  A. $16.00  B. $0.00  C. $8.00  D. $76.00 This was the choice you selected. You are correct. 24. volume_downRead to Me Which patient required a second billing? Earned 4.00 of 4.000 points.  A. Frank Alba  B. Joanne Carty This was the choice you selected. You are correct.  C. Nikki Salazar  D. Mae Griggs 25. volume_downRead to Me Which patient received a refund? Earned 4.00 of 4.000 points.  A. Rob Martin This was the choice you selected. You are correct.  B. Frank Alba  C. Joanne Carty  D. Nikki Salazar bug_report Copyright © 2024 U.S. Care