Insurance 101! Brain Boost/Knowledge Check

insurance 101

Now that you have completed Insurance 101 training, it's time totest your knowledge!

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Question 1/12

0 points earned

FOR 25 POINTS

An organization that processes patient eligibility, services, claims, enrollment, and payments is called what?

Payer

Plan

Network

25 points earned

RIGHT ON!

An organization that processes patient eligibility, services, claims, enrollment, and payments is called a "payer."

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Question 2/12

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FOR 100 POINTS

Which of the following plans always requires a PCP? Select one.

EPO

PPO

HMO

125 points earned

CORRECT!

An HMO plan always requires a PCP.

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Question 3/12

125 points earned

FOR 75 POINTS

With this type of plan, patients do NOT need a referral to see a specialist.

HMO

POS

PPO

200 points earned

AMAZING!

With a PPO plan, patients do NOT need a referral to see a specialist.

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Question 4/12

200 POINTS

FOR 25 POINTS

Select the correct definition of a "permanent" address when shown in a patient's Epic chart.

An address used for sending appointment reminders, letters, and lab results

An address for the person who is the subscriber of the insurance

An address used to store a patient's billing address

225 points earned

OUTSTANDING!

A "permanent" address shown in a patient's Epic chart is an address used for sending appointment reminders, letters, and lab results.

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Question 5/12

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FOR 500 POINTS

Select the correct definition of TriCare.

A healthcare program for all retirees in the United States

A healthcare program of the US Department of Defense Military Health System

A healthcare program for Washington State Medicaid subscribers

725 points earned

AWESOME!

TriCare is a healthcare program of the US Department of Defense Military Health System and serves active-duty and retired military personnel and their dependents, survivors, and former spouses.

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Question 6/12

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FOR 75 POINTS

Which of the following is NOT a requirement of a complete registration?

Guarantor

Patient demographics

Copay

800 points earned

YOU GOT IT!

A copay is NOT a requirement of a full registration, while verifying the patient demographics and the guarantor are requirements.

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Question 7/12

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FOR 100 POINTS

If you make updates to the patient's demographics in Epic, you do NOT need to pull that info into the guarantor or subscriber demographics.

True

False

900 points earned

UNSTOPPABLE!

If you make updates to the patient's demographics in Epic, you DO need to pull that info into the guarantor or subscriber demographics.

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Question 8/12

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FOR 250 POINTS

What are the 2 identifiers ABC Medical Center requires when accessing a patient's chart in Epic?

Full name and address

Full name and date of birth (DOB)

Date of birth and phone number

1150 points earned

RIGHT!

Full name and date of birth (DOB) are the 2 patient identifiers Valley Medical Center requires when accessing a patient's chart in Epic.

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Question 9/12

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FOR 50 POINTS

What is the amount of the Good Faith Deposit (GFD) for a typical office visit at Primary Care?

$125.00

$140.00

$100.00

1200 points earned

INCREDIBLE!

The amount of the Good Faith Deposit (GFD) for a typical office visit at Primary Care is $125.

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Question 10/12

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FOR 250 POINTS

In-network or contracted healthcare organizations agree to charge no more than a negotiated amount for services.

True

False

1450 points earned

SUPER!

In-network or contracted healthcare organizations sign a contract with an isurance company and agree to charge no more than a negotiated amount for services.

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Question 11/12

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FOR 500 POINTS

The Medicare Secondary Payer Questionnaire (MSPQ) only has to be completed once per month.

True

False

1950 points earned

WOO-HOO!

The Medicare Secondary Payer Questionnaire (MSPQ) must be completed at every encounter.

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Question 1/10

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FOR 50 POINTS

Billy is a dependent on both parents' health insurance plans. Billy's father's birthday is May 1, 1991, and his mother's birthday is June 18, 1991. Based on the Birthday Rule, which parent's insurance plan is primary?

Billy's father's plan

Billy's mother's plan

2000 points earned

SHAZAM!

According to the Birthday Rule, Billy's father's insurance plan is primary because his father's birthay month/day of May 1 comes before the mother's birthday month/day of June 18. Remember, the birth year is not a factor.

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