CMAA Insurance Verification and Processing 2

Question 1

What is the primary purpose of verifying insurance eligibility before an appointment?

Accepted Answer

To ensure the practice will receive payment

Answer

To determine medical history

Answer

To schedule with the correct provider

Answer

To assign a medical record number

Question 2

What information is typically found on the back of an insurance card?

Accepted Answer

Claims address and customer service phone number

Answer

Patient DOB and SSN

Answer

Primary care physician name

Answer

Copayment for all services

Question 3

A patient has both Medicare and employer commercial insurance. Which is typically primary?

Accepted Answer

Commercial plan is primary if employer has 20+ employees

Answer

Medicare is always primary

Answer

Patient chooses which is primary

Answer

Plan with lower premium is primary

Question 4

What does 'prior authorization' mean in insurance processing?

Accepted Answer

Insurance must approve certain services before they are performed

Answer

Patient must pay before service

Answer

Referring physician must write a letter

Answer

Patient must sign a consent form

Question 5

What is a referral in managed care insurance plans?

Accepted Answer

An authorization from the PCP for the patient to see a specialist

Answer

A letter from the patient requesting a specialist

Answer

A transfer of medical records

Answer

An insurance company recommendation

Question 6

A patient has a $2,000 deductible and has met $1,500. The visit costs $200. How much applies to the deductible?

Accepted Answer

$200

Answer

$500

Answer

$1,500

Answer

$0