CHAA Insurance Verification and Eligibility Flashcards
7 cards from real CHAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 CHAA Insurance Verification and Eligibility flashcards as text
A 67-year-old patient is still working full-time and covered by an employer group health plan from a company with 50 employees. Which payer is primary?
Answer: The employer group health plan
For working-aged beneficiaries 65+ covered through current employment at an employer with 20 or more employees, the group health plan is primary to Medicare.
A patient with end-stage renal disease has both an employer group health plan and Medicare. During the 30-month coordination period, which plan pays first?
Answer: The employer group health plan
During the ESRD 30-month coordination period, the group health plan is primary and Medicare is secondary.
For a Medicare patient receiving recurring outpatient therapy services, how often should the Medicare Secondary Payer (MSP) questionnaire information be re-verified?
Answer: Every 90 days
CMS allows recurring outpatient MSP information to be verified once every 90 days.
A patient's allowed amount is $1,000, they have $200 of deductible remaining, and their plan pays 80% after the deductible. What is the patient's responsibility?
Answer: $360
The patient pays the $200 deductible plus 20% of the remaining $800 ($160), totaling $360.
A child's divorced parents both carry health insurance, and there is no court decree assigning responsibility. Which plan is typically primary?
Answer: The custodial parent's plan
Absent a court order, NAIC coordination rules make the custodial parent's plan primary for dependents of divorced or separated parents.
Which transaction does a provider receive in response to submitting an electronic HIPAA 270 eligibility inquiry?
Answer: 271
The 271 is the eligibility benefit response to a 270 inquiry.
A patient is injured in a car accident and has both auto insurance with medical payments/PIP coverage and a commercial health plan. Which is generally billed first?
Answer: The auto insurance medical payments/PIP coverage
Auto no-fault or medical payments coverage is generally primary to health insurance for accident-related injuries.
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Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- naham.org — Eligibility, exam format, passing score, time limit, score validity, test delivery, fees, registration, retake fee, score release · verified Oct 2026