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Multiple Choice
Identify the choice that best completes the statement or answers the question.

____    1. The amount of money paid to keep an insurance policy in force is the:
           a. premium
           b. deductible
           c. copay
           d. co-insurance
____    2. Approximately what percent of people in the United States have no health insurance coverage?
           a. 10%
           b. 20%
           c. 40%
           d. 50%
____    3. Health insurance designed for military dependents and retired military personnel is:
           a. CHAMPVA
           b. TRICARE
           c. Medicare
           d. Medicaid
____    4. A policy that covers a number of people under a single master contract issued to the employer or to
             an association with which they are affiliated and that is not self-funded is usually called:
             a. group coverage
             b. individual coverage
             c. a government plan
             d. a self-insured plan
____    5.   Entities that make payment on an obligation or debt but are not parties of the contract that created
             the debt are called:
             a. riders
             b. service benefit plans
             c. third-party payors
             d. capitation
____    6.   The federal and state-sponsored health insurance program for the medically indigent is called:
             a. Medicare
             b. Medicaid
             c. Medigap
             d. MediCal
____    7.   The physician who enters into a contract with an insurance company and agrees to certain rules and
             regulations is called a:
             a. participating provider
             b. paying provider
             c. physician provider
             d. None of the above
____    8.   A review of individual cases by a committee to make sure that services are medically necessary and
             to study how providers use medical care resources is called a(n):
            a.  credentialing committee review
            b.  peer review committee evaluation
            c.  utilization review
            d.  audit committee review
____   9.   Formerly called catastrophic insurance, which type of protection provides coverage for especially
            large medical bills resulting from a prolonged illness?
            a. Disability protection
            b. Basic medical
            c. Hospitalization
            d. Major medical
____ 10.    Which of the following expenses would be paid by Medicare Part B?
            a. Inpatient hospital charges
            b. Hospice services
            c. Physician office visits
            d. Home healthcare charges
____ 11.    Which part of Medicare covers prescription drug services?
            a. A
            b. B
            c. C
            d. D
____ 12.    Health insurance benefits are determined by:
            a. indemnity schedules
            b. service benefit plans
            c. relative value studies
            d. All of the above
____ 13.    Which type of referral is usually processed immediately?
            a. Regular
            b. Urgent
            c. STAT
            d. All of the above are immediately processed
____ 14.    If Mr. Jones’ insurance has a $500 deductible and a $50 surgery copay then pays 80% of the charges,
            how much will his policy pay on his bill of $4359.00?
            a. $3027.20
            b. $3047.20
            c. $3047.00
            d. $3067.50
____ 15.    The individual entitled to receive benefits from an insurance policy or program is called the:
            a. beneficiary
            b. insured
            c. payor
            d. carrier
Answer Section


      1.   ANS:   A   PTS:   1
      2.   ANS:   B   PTS:   1
      3.   ANS:   B   PTS:   1
      4.   ANS:   A   PTS:   1
      5.   ANS:   C   PTS:   1
      6.   ANS:   B   PTS:   1
      7.   ANS:   A   PTS:   1
      8.   ANS:   C   PTS:   1
      9.   ANS:   D   PTS:   1
     10.   ANS:   C   PTS:   1
     11.   ANS:   D   PTS:   1
     12.   ANS:   D   PTS:   1
     13.   ANS:   C   PTS:   1
     14.   ANS:   B   PTS:   1
     15.   ANS:   A   PTS:   1

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