CBCS Patient Registration and Financial Responsibilities 2 — Questions and Answers
Question 1: What is a deductible in health insurance?
- A fixed dollar amount paid per visit
- The annual amount a patient pays out-of-pocket before insurance begins covering costs (Correct answer)
- The percentage the insurer pays after the copay
- The monthly premium paid for coverage
Correct answer: The annual amount a patient pays out-of-pocket before insurance begins covering costs
A deductible is the amount a patient must pay annually before the insurance company begins paying for covered services.
Question 2: What does 'coinsurance' mean in health insurance billing?
- Dual coverage from two insurers
- The percentage of costs a patient pays after the deductible is met (Correct answer)
- A fixed per-visit fee
- The maximum benefit limit
Correct answer: The percentage of costs a patient pays after the deductible is met
Coinsurance is the percentage of covered costs the patient is responsible for after meeting their deductible (e.g., 20% after a 80/20 plan).
Question 3: Which registration form obtains the patient's permission for treatment and acknowledges their financial responsibility?
- HIPAA Privacy Notice
- Patient consent and financial responsibility form (Correct answer)
- Assignment of benefits
- ABN
Correct answer: Patient consent and financial responsibility form
The patient consent and financial responsibility form obtains consent for treatment and informs the patient they are responsible for any unpaid balances.
Question 4: A patient presents without an insurance card. What is the BEST first step for the billing staff?
- Refuse service until the card is provided
- Ask the patient for their insurance name, ID, and group number to verify eligibility by phone or portal (Correct answer)
- Bill the patient as self-pay automatically
- Skip insurance verification
Correct answer: Ask the patient for their insurance name, ID, and group number to verify eligibility by phone or portal
Staff should collect the patient's insurance information verbally or via a portal to verify eligibility in real time, ensuring the claim can be submitted correctly.
Question 5: What is a guarantor in the context of patient accounts?
- The patient's primary care physician
- The person financially responsible for the patient's account (Correct answer)
- The insurance company
- The referring provider
Correct answer: The person financially responsible for the patient's account
The guarantor is the individual (often the patient or a parent/guardian) who is legally responsible for paying the medical bill.
Question 6: What does 'out-of-pocket maximum' mean on a health insurance plan?
- The highest premium the patient will pay
- The cap on total costs a patient pays in a year, after which the insurer covers 100% (Correct answer)
- The maximum number of visits covered
- The maximum amount the insurer will pay
Correct answer: The cap on total costs a patient pays in a year, after which the insurer covers 100%
The out-of-pocket maximum is the annual cap on a patient's cost-sharing; once reached, the insurer pays 100% of covered services for the rest of the year.
CBCS Patient Registration and Financial Responsibilities 2
What is a deductible in health insurance?