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