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Insurance Verification Week 2 Prep Quiz

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.

___________ is the amount you pay to share the cost of covered services after your deductible has been paid. The rate is usually a percentage.

a)

Deductible

b)

Coinsurance

c)

MOOP

d)

Copay

2.

Which states are affected by the Synapse process? Click all that apply. (2 states)

a)

TN

b)

NC

c)

GA

d)

WA

3.

From the options below, which plan pays Part B Deductible?

a)

Plan N

b)

Plan G

c)

Plan B

d)

Plan C

4.

True or False: Authorization is required for Type 1 and Type 2 for Aetna Medicare Advantage plans for CGM products.

a)

True

b)

False

5.

If patient has 2ndary Plan which is MCR Supp Plan F and has MCR Ded Balance of 200. How much should be the patient's responsibility?

a)

FULL COST UNTIL MCR DED MET THEN $0

b)

$0 Copay

c)

20% COINS

6.

If the Secondary Insurance is Medicaid California, where will you get the details for your MC Comment?

a)

Availity

b)

Medi-cal Website

c)

Experian

d)

Zirmed

7.

Which from the options below is a type of Medicaid program that will cover PART B premiums only. Select all that apply. (2 answers)

a)

QMB

b)

SLMB

c)

QI

d)

QDWI

8.

What is the name of the document we use to check if we are contracted with the secondary Medicaid?

a)

One Note

b)

Medicaid Fee Schedule

c)

Synapse Lookup Tool

d)

Medicaid Paid 2021

9.

To whom should we route the events with Therapy Type: Insulin?

a)

Adrianna Lopez

b)

Devonna Martin

c)

Karina Rivas

d)

Edgar Cuevas

10.

What is the Rx Group# to use when coding if the secondary plan is Blue Shield Federal and the pharmacy on stamp shows inactive?

a)

We should not code Rx because it is inactive on Medicare stamp

b)

65006500

c)

DODA