Health Insurance Test Questions Sample Essay

1. Explain what is meant by respondeat superior
2. Explain medical malpractice insurance and why it is of import to doctors and other health care professionals
3. Explain what is meant by medical necessity and give an illustration
4. Explain the importance of moralss in the professional workplace
5. List the degrees of the Healthcare Common Procedure Coding System
6. What is meant by range of pattern?

7. List the four types of insurance that healthcare suppliers and installations typically purchase to cover their employees
8. Why is preauthorization of import?
9. Explain what is meant by a clasp harmless clause
10. Describe what is meant by coding
11. What is meant by medical attention?
12. Give the definition of wellness insurance
13. What is the definition of an electronic wellness record?

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14. What is the importance of NCCI?
15. What is the Resource-Based Relative Value Scale ( RBRVS ) System?
16. What are usual and sensible payments based on?
17. What medical pattern maps does entire pattern direction package automate?
18. Describe continuity of attention
19. In 1947. the Taft-Hartley Act initiated the creative activity of third-party decision makers ( TPAs ) . What is a third-party decision maker?
20. What does major medical insurance screen. and what are some of the drawbacks of these policies?
21. What is Title XVII coverage and who does it cover?

22. What is Title XIX coverage and who does it cover?
23. After the patient pays the copayment and the remunerator reimburses the supplier harmonizing to its fee agenda. what happens to the staying balance?
24. What is the intent of a managed attention program?

25. What is a fee-for-service program?
26. What is the function of the primary attention supplier ( PCP ) ?
27. What is the function of utilization direction ( or use reappraisal ) ?
28. What is the difference between preadmission enfranchisement ( PAC ) and

29. Explain instance direction

30. What is the ground for a 2nd surgical sentiment?
31. Why did Medicare prohibit joke clauses?
32. What is a medical foundation?
33. What is a point-of-service program?
34. What is a wellness care organisation ( HMO ) program?

35. What is a preferable supplier organisation ( PPO ) ?
36. Explain the advantages of a ternary option program
37. Define concurrent reappraisal
38. List the five types of wellness care organisations on your text edition
39. What is the intent of the NCQA?

40. Explain the difference between assignment of benefits and accept assignment
41. Explain the difference between a take parting supplier ( PAR ) and a non-participating supplier ( non-PAR )
42. When a provider’s office contacts the remunerator to verify a patient’s insurance eligibility and benefit position. HIPAA privateness criterions mandate that four countries of pertinent information be provided. Name them
43. Explain primary insurance versus secondary insurance

44. What is the birthday regulation?
45. What is the gender regulation?
46. Define brush signifier. and distinguish between a superbill and a chargemaster
47. What is the patient leger?
48. What is a clearinghouse?
49. What does the claims adjudication procedure verify?
50. Explain allowed charges


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