Question | Answer |
TIME LIMITS ATATED IN INDIVIDUAL HEALTH INSURANCE POLICIES ABOUT AN INSURANCE COMPANY'S OBLIGATION TO PAY BENEFITS ARE THE SAME FOR ALL INSURANCE COMPANIES | FALSE |
THERE IS STANDARDIZATION OF FORMAT FOR THE EXPLANATION OF BENEFIT DOCUMENT FOR ALL PRIVATE INSURANCE CARRIERS | FALSE |
THE INSURANCE INDUSTRY IS PROTECTED BY A SPECIAL EXEMPTION FROM THE FEDERAL TRADE COMMISSION | TRUE |
INSURANCE COMPANIES ARE RATED ACCORDING TO THE NUMBER OF COMPLAINTS RECIEVED ABOUT THEM | TRUE |
THE STATUS OF ELECTRONIC INSURANCE CLAIMS MAY BE ACCESSED QUICKLY ELECTRONICALLY OR TELEPHONICALLY BY DIGITAL RESPONSE SYSTEM | TRUE |
INQUIRES ABOUT INSURANCE CLAIMS MAY BE IN WRITING OR BY TELEPHONE | TRUE |
A REJECTED INSURANCE CLAIM SHOULD BE CORRECTED AND SENT FOR REVIEW OR APPEAL | FALSE |
APPROXIMATELY 50% OF INDIVIDUALS PURSUE APPEALS ON A DENIED INSURANCE CLAIM | FALSE |
IN THE CASE OF A MEDICARE PART B REDETERMINATION CARRIERS HAVE BEEN INSTRUCTED TO PAY AN APPEALED INS | TRUE |
THE HEARING PROCESS IS MORE THEN THE AMOUNT OF THE CLAIM | TRUE |
IF YOU HAVE A DENIED INSURANCE CLAIM YOU SHOULD CHANGE THE INFORMATION AND RESUBMIT THE CLAIM | FALSE |
ROUTINE USE OF TOO MANY NONSPECIFIC DIAGNOSTIC CODES MAY RESULT IN DOWNCODING | TRUE |
IN ANY TYPE OF OVERPAYMENT SITUATION ALWAYS CASH THE THIRD PARTY PAYER'S CHECK AND WRITE A REFUND CHECK PAYABLE TO THE ORIGINATOR OF THE OVERPAYMENT | TRUE |
IF THE PROVIDER IS NOTIFIED BY A COMMERICAL INSURANCE CARRIER THAT AN OVERPAYMENT HAS BEEN MADE INVESTIGATE THE REFUND REQUEST | TRUE |
A LEVEL 1 MEDICARE REDETERMINATION MAY BE MADE EITHER BY TELEPHONE IN WRITING OR BY SUBMITTING A CMS-20027 FORM | TRUE |
A PEER REVIEW IS USUALLY DONE BEFORE THE APPEAL PROCESS | FALSE |
APPEAL DECISIONS ON MEDICARE UNASSIGNED INSURANCE CLAIMS ARE SENT TO THE PATIENT | TRUE |
THE HIGHEST LEVEL OF A MEDICARE REDETERMINATION IS WITH AN ADMININISTRATIVE LAW JUDGE HEARING | FALSE |
THE CODES IN THE EYE AND OCULAR ADNEXA SUBSECTION ARE BILATERAL CODES | FALSE |
THE DESTRUCTION CODES IN THE POSTERIOR SEGMENT SUBSECTION INCLUDE ONE OR MORE SESSIONS | TRUE |
IF AN INSURED IS IN DISAGREEMENT WITH THE INSURER FOR SETTLEMENT OF A CLAIM A SUIT MUST BEGIN WITHIN | 3 YEARS |
IF A PAYMENT PROBLEM DEVELOPS WITH AN INSURANCE COMPANY AND THE COMPANY IGNORES CLAIMS AND EXCEEDS TIME LIMITS TO PAY A CLAIM IT IS PRUDENT TO CONTACT THE | STATE INSURANCE COMMISSIONER |
THE DOCUMENT TOGETHER WITH THE PAYMENT VOUCHER THAT IS SENT TO A PHYSICIAN WHO HAS ACCEPTED ASSIGNMENT OF BENEFITS IS REFERRED TO AS AN | EOB |
WHEN RECIEVING PAYMENT FROM A PRIVATE INSURANCE CARRIER CHECK THE AMOUNT OF PAYMENT ON THE EOB WITH THE | PATIENT'S FINANCIAL ACCOUNTING RECORD |
AN INSURANCE CLAIMS REGISTER PROVIDES A | FOLLOW UP PROCEDURE FOR INSURANCE CLAIMS |
PENDING OR RESUBMITTED INSURANCE CLAIMS MAY BE TRACKED THROUGH A | TICKLER FILE |
THERE ARE SEVERAL WAYS TO FILE PENDING INSURANCE CLAIMS WHAT IS THE BEST WAY TO FILE SO THAT TIMELY FOLLOW UP CAN BE MADE? | FILE BY PATIENT'S LAST NAME |
A FOLLOW UP EFFORT MADE TO AN INSURANCE COMPANY TO LOCATE THE STATUS OF AN INSURANCE CLAIM IS CALLED A /AN | INQUIRY |
IF AN INSURANCE CLAIM HAS BEEN LOST BY THE INSURANCE CARRIER THE PROCEDURE TO FOLLOW IS TO | ASK IF THERE IS A BACKLOG OF CLAIMS AT THE INSURANCE OFFICE |
AN EXAMPLE OF A TECHNICAL ERROR ON AN INSURANCE CLAIM IS | DUPLICATE DATES OF SERVICE |
AN INSURANCE CLAIM WITH AN INVALID PROCEDURE CODE WOULD BE | REJECTED |
WHAT SHOULD YOU DO IF AN INSURANCE CARRIER REQUESTS INFORMATION ABOUT ANOTHER INSURANCE CARRIER | PROVIDE THE INFORMATION |
AN INSURANCE CLAIM WITH A BUNDLED SERVICE WOULD BE | PAID |
AN INSURANCE CLAIM FOR WHICH PRIOR APPROVAL WAS NOT OBTAINED WOULD BE | PAID |
WHAT SHOULD BE DONE IF AN INSURANCE CLAIM DENIAL IS RECIEVED BECAUSE A BILLED SERVICE WAS NOT A PROGRAM BENEFIT? | SEND THE PATIENT A STATEMENT WITH A NOTATION OF THE RESPONSE FROM THE INSURANCE COMPANY |
WHAT SHOULD BE DONE IF AN INSURANCE COMPANY DENIES A SERVICE STATING IT WAS NOT MEDICALLY NECESSARY AND THE PHYSICIAN BELIEVES IT WAS? | REBILL WITH A LETTER OF EXPLANATION FROM THE PHYSICIAN |
WHEN DOWNCODING OCCURS PAYMENT WILL | BE LESS |
IF AN INSURANCE COMPANY ADMITS THAT A PATIENT SIGNED AN ASSIGNMENT OF BENEFITS DOCUMENT AND THAT IT INADVERTENLY PAID THE PATIENT INSTEAD OF THE PHYSICIAN THE INSURANCE COMPANY SHOULD | PAY THE PHYSICIAN WITHIN 2-3 WEEKS AND HONOR THE ASSIGNMENT EVEN BEFORE THE COMPANY RECOVERS ITS MONEY FROM THE PATIENT |
THE TOTAL NUMBER OF LEVELS OF REDETERMINATION THAT EXIST IN THE MEDICARE PROGRAM IS | FIVE |
THE FIRST LEVEL OF APPEAL IN THE MEDICARE PROGRAM IS | REDETERMINATION |
THE CORRECT METHOD TO SEND DOCUMENTS FOR A MEDICARE RECONSIDERATION (LEVEL2) IS BY | CERTIFIED MAIL WITH RETURN RECIEOT REQUESTED |
A REQUEST FOR A MEDICARE ADMINISTRATIVE LAW JUDGE HEARING CAN BE MADE IF THE AMOUNT IN CONTROVERSY IS AT LEAST | $120.00 |
HOW MANY LEVELS OF REVIEW EXIST FOR TRICARE APPEAL PROCEDURES? | THREE |
TRICARE APPEALS ARE NORMALLY RESOLVED WITHIN | 60 DAYS |
IN A TRICARE CASE A REQUEST FOR AN INDEPENDENT HEARING MAY BE PURSUED IF THE AMOUNT IN QUESTION IS | $300 OR MORE |
CATARACT AND LENS REPLACEMENT USES___DIFFERENT APPROACHES | 3 |
STRABISMUS SURGERY | CORRECTS THE MUSCLE MISALIGNMENT |
THE INNERMOST LAYER OF THE EYE IS THE | RETINA |
AN INSTRUMENT USED TO MEASURE INTRAOCULAR PRESSURE IS | TONOMETER |
THE COLORED MEMBRANE ATTACHED TO THE CILIARY BODY IS | IRIS |
IN THE TERM MIOTIC THE COMBINING FORM MI/O MEANS | LESS, SMALL |
IN THE TERM RETROLENTAL THE PREFIX RETRO- MEANS | BEHIND |
THE MEIBOMIAN GLANDS SECRETE | SEBUM |
THE MEDICAL TERM FOR NORMAL OR PERFECT VISION IS | EMMETROPIA |
THE ROOT IN THE TERM KEATOCONJUNCTIVITIS MEANS | JOIN TOGETHER |
AN AGENT THAT CAUSES THE PUPIL TO DILATE IS CALLED | MYDRIATIC |
THE MEASUREMENT OF THE CORNEA IS CALLED | KERATOMETRY |
HOW MANY EYE MUSCLES CONTROL MOVEMENT OF THE EYE? | SIX |
A CONDITION IN WHICH THE PUPILS ARE UNEQUAL IS TERMED | ANISOCORIA |
___IS THE PROCESS OF THE EYES MAKING ADJUSTMENTS FOR SEEING AT VARIOUS DISTANCE | ACCOMMODATION |
DRYNESS OF THE CONJUNCTIVA IS CALLED | XEROPHTHALMIA |
THE___IS THE OPENING IN THE CENTER OF THE IRIS | PUPIL |
CONJUNCTIVITIS IS OFTEN CALLED | PINKEYE |
THE TERM USED TO DESCRIBE THE CONDITION OF AN EYE BEING TURNED INWARD IS | ESOTROPIA |
OPACITY OF THE CRYSTALLINE LENS IS CALLED | CATARACT |
AN UNUSUAL INTOLERANCE OF LIGHT IS KNOWN AS | PHOTOPHOBIA |
AN INVOLUNTARY CONSTANT RYTHMIC MOVEMENT OF THE EYEBALL IS CALLED | NYSTAGMUS |
IN THE TERM MYDRIATIC, THE ROOT MYDRIAT MEANS | DILATION, WIDEN |
A MALIGNANT TUMOR ARISING FROM THE GERM CELL OF THE RETINA IS | RETINOBLASTOMA |
ALL OF THE FOLLOWING MAKE UP THE EXTERNAL STRUCTURE OF THE EYE EXCEPT | UVEA |
THE ANTERIOR CHAMBER IS FILLED WITH | AQUEOUS HUMOR |
A SURGICAL PROCEDURE THAT MAY BE PERFORMED TO CORRECT MYOPIA IS KNOWN AS | RADIAL KERATOTOMY |
THE SUFFIX IN BLEPHAROPTOSIS MEANS | DROOPING |
IN OLDER ADULTS THE LEADING CAUSE OF NEW CASES OF BLINDNESS IS | MACULAR DEGENERATION |
THE MIDDLE OR VASCULAR LAYER OF THE EYEBALL IS CALLED | UVEA |
THE MEDICAL TERM FOR NIGHT BLINDNESS IS | NYCTALOPIA |
LAZY EYE IS ALSO KNOWN AS | AMBLYOPIA |
___IS USED TO IDENTIFY CHANGES IN THE BLOOD VESSELS IN THE EYE AND TO DIAGNOSE SYSTEMIC DISEASES | OPHTHSLMOSCOPY |
THE __IS THE ANTERIOR TRANSPARENT PORTION OF THE EYEBALL | CORNEA |
THE MIDDLE LAYER OF THE EYEBALL IS KNOWN AS THE | UVEA |
MACULAR DEGENERATION INVOLES THE MACULAR AREA OF THE | RETINA |
THE ROOTS IN ORTHOPTICS MEANS | STRAIGHT |
IN THE TERM KERATOCONJUNCTIVITIS THE COMBING FORM KERAT/O MEANS | PUPIL |
THE MEASUREMENT OF THE INTRAOCULAR PRESSURE OF THE EYE IS | TONOMETRY |
THE PIGMENT NECCESSARY FOR NIGHT VISION IS | RHODOPSIN |
THE SMALL DEPRESSION LOCATED IN THE MACULA LUTEA IS KNOWN AS THE | FOVEA CENTRALIS |
SURGICAL DESTRUCTION AND REMOVAL OF THE LENS TERMED | PHACOLYSIS |
IN THE TERM CRYOSURGERY THE COMBINING FORM CRY/O MEANS | COLD |
IN THE TERM PHACOEMULSIFICATION THE COMBINING FORM PHAC/O MEANS | LENS |
A PROCESS OF REMOVING AN ENTIRE PART OR MASS WITHOUT RUPTURE IS CALLED | ENUCLEATION |
THE PROCESS OF USING ULTRASOUND TO DISINTEGRATE A CATARACT IS KNOWN AS | PHACOEMULSIFICATION |
IN THE TERM CONJUNCTIVITIS THE ROOT CONJUNCTIV MEANS | TO JOIN TOGETHER |
DRYNESS OF THE CONJUNCTIVA IS TERMED | XEROPHTHALMIA |
AN AGENT THAT CAUSES THE PUPIL TO COTRACT IS CALLED | MIOTIC |
THE MOST COMMON SURGERY TO REMOVE A CATARACT IS | PHACOEMULSIFICATION |
A DROOPING OF THE UPPER EYELID IS KNOWN AS | BLEPHAROPTOSIS |
A CONDITION OF HARDENING OF THE CRYSTALLINE LENS IS CALLED | PHACOSCLEROSIS |
A PHYSICIAN WHO SPECIALIZES IN THE STUDY OF THE EYE IS | OPHTHALMOLOGIST |
IN THE TERM NYCTALOPIA THE ROOT NYCTAL MEANS | NIGHT |
THE MEDICAL TERM FOR FARSIGHTEDNESS IS | HYPEROPIA |
THE AGENT USED TO CAUSE PUPILS TO CONTRACT IS A/AN | MIOTIC |
THE COLORED TISSUE ATTACHED TO THE CILIARY BODY IS THE | IRIS |
THE MEDICAL TERM FOR DULLNESS OF VISION IS | AMBLYOPIA |
BETA BLOCKERS INCREASE THE PRODUCTION OF INTRAOCULAR FLUID | FALSE |
THE IRIS IS ATTACHED TO THE CHOROID | FALSE |
THE NASOLACRIMAL DUCT DRAINS LACRIMAL FLUID INTO THE NOSE | TRUE |
THE PROTECTIVE COVERING FOR THE EXPOSED SURFACE OF THE EYEBALL IS THE SCLERA | FALSE |
THE LEADING CAUSE OF BLINDNESS OVER AGE 55 IS MACULAR DEGRNERATION | TRUE |
THE CIRCULAR OPENING IN THE CENTER OF THE IRIS IS CALLED THE PUPIL | TRUE |
THE ANTERIOR TRANSPARENT PORTION OF THE EYE'S FIBROUS OUTER SURFACE IS THE SCLERA | FALSE |
AN INCREASED AMOUNT OF TEARS CAN BE A SYMPTOM OF CONJUNCTIVITIS | TRUE |
AQUEOUS HUMOR IS LOCATED IN THE ANTERIOR CHAMBER | TRUE |
CATARACT REMOVAL IS ONE OF THE MOST COMMON OPERATIONS PERFORMED IN THE UNITED STATES TODAY | TRUE |