FREE NHA Revenue Cycle and Health Insurance Claims Questions and Answers

Question 1

Which of the following is typically the first step in the healthcare revenue cycle?

Accepted Answer

Patient pre-registration

Answer

Claims submission

Answer

Payment posting

Answer

Denial management

Question 2

The CMS-1500 form is used to submit claims for which type of services?

Accepted Answer

Physician office visits and procedures

Answer

Inpatient hospital stays

Answer

Skilled nursing facility services

Answer

Prescription drugs from a pharmacy

Question 3

A patient's insurance plan requires them to pay $500 out-of-pocket for medical services before the insurance company will begin to pay. This amount is known as the:

Accepted Answer

Deductible

Answer

Copayment

Answer

Premium

Answer

Coinsurance

Question 4

What is the process of reviewing a claim by an insurance carrier to determine payment or denial called?

Accepted Answer

Adjudication

Answer

Scrubbing

Answer

Pre-authorization

Answer

Appealing

Question 5

A document sent to a patient from their insurance company that details how a claim was processed is known as a(n):

Accepted Answer

Explanation of Benefits (EOB)

Answer

Remittance Advice (RA)

Answer

CMS-1500 Claim Form

Answer

Advance Beneficiary Notice (ABN)

Question 6

Which of the following is an example of a government-sponsored health insurance plan?

Accepted Answer

Medicare

Answer

Blue Cross Blue Shield

Answer

Aetna

Answer

Cigna