WorksheetsHealth Insurance Basics
Total questions: 25
Worksheet time: 13mins
We pay for medical services by:
using insurance, cash, or credit/debit cards
only with checks
by bartering goods
with cryptocurrency only
Who are typically involved in the partnership regarding healthcare costs?
Patients, providers, and insurance companies
Only patients
Only providers
Only insurance companies
Fill in the blank: A contract in which an individual pays a monthly or annual fee (premium) in exchange for financial protection against unexpected medical costs is called ________.
Insurance
Loan
Mortgage
Lease
Fill in the blank: The regular, fixed amount a person pays to an insurance company, usually monthly, to keep their insurance coverage active is called ________.
Premium
Deductible
Copayment
Claim
Fill in the blank: The amount of money a patient must pay out-of-pocket for covered medical services before their insurance plan begins to pay is called ________.
Deductible
Premium
Copayment
Coinsurance
Fill in the blank: A fixed amount a patient pays for a covered healthcare service after they have paid their deductible is called ________.
Co-payment (Co-pay)
Premium
Out-of-pocket maximum
Coinsurance
Fill in the blank: The process of converting healthcare diagnoses, procedures, and services into universal alphanumeric codes, which is how providers bill insurance companies, is called ________.
Medical Coding
Medical Transcription
Medical Auditing
Medical Billing
What is a premium in health insurance?
The amount you pay for care before insurance starts paying
The 'entry fee' for your health insurance plan
The amount your insurance pays for your care
The cost of your medication
How does a premium work in health insurance?
You pay it only when you use medical services
You pay this amount every month, regardless of whether you use medical services. It keeps your coverage active.
You pay it once a year
You pay it only for emergency services
What is a deductible in health insurance?
The amount you pay for your gym membership
The amount you must pay for care before your insurance starts paying
The monthly fee for your insurance
The cost of your medication
Fill in the blank: If you have a 2,000 health insurance deductible and receive a covered 5,000 surgery, you pay the first _____, and your insurance plan will pay the rest.
$2,000
$1,000
$3,000
$5,000
Key Difference: You pay a premium to _____ insurance, and you pay a deductible to _____ it for significant services.
have; use
use; have
cancel; renew
renew; cancel
Which of the following is an analogy for a premium?
Paying for each gym visit
Like a gym membership fee—you pay it to have access to the gym, even if you don't go
Paying for each medical service
Paying only when you use the gym
What is a co-payment (co-pay)?
A fixed, flat fee you pay for a service.
A percentage of your total medical bill.
The total amount your insurance pays for you.
A monthly premium you pay for insurance.
How does a co-payment (co-pay) work?
Paid at the time of service, after you have met your deductible (unless the plan waives the deductible for that service).
Paid only at the end of the year for all services received.
Paid directly to your employer before receiving any medical care.
Paid only if your insurance plan is canceled.
What is coinsurance?
A percentage of the cost of a service you are responsible for paying.
A type of savings account for medical expenses.
A fixed amount you pay for a medical service.
A government health insurance program.
How does coinsurance work?
Paid after you have met your deductible. You and the insurance company share the costs.
It is a fixed amount you pay for each doctor visit.
It covers all your medical expenses without any payment from you.
It is the total amount you pay before insurance starts covering costs.
What is the key difference between a co-pay and coinsurance?
A co-pay is a fixed amount; coinsurance is a percentage.
A co-pay is paid only once; coinsurance is paid monthly.
A co-pay covers all medical expenses; coinsurance covers only prescriptions.
A co-pay is a percentage; coinsurance is a fixed amount.
Which of the following is an example of a co-payment?
Paying 20% of the bill after deductible
Paying $20 for a doctor's visit
Paying the remaining 80% of the bill
Paying after the insurance company pays their share
With a 20% coinsurance, you pay ___% of the bill, and the insurance company pays the remaining ___%.
20; 80
80; 20
50; 50
10; 90
What is the purpose of medical coding as described in 'The Language of Billing: Medical Coding'?
To bridge between a doctor's visit and the insurance claim
To diagnose patients
To treat diseases
To schedule appointments
Fill in the blank: Providers use specific codes to describe what was ______ and why. (From 'The Language of Billing: Medical Coding')
done
charged
written
prescribed
Which type of code describes the patient's diagnosis or condition?
ICD Codes (International Classification of Diseases)
CPT Codes (Current Procedural Terminology)
Both A and B
None of the above
Which type of code describes the services provided, such as 99213 for a routine office visit?
ICD Codes
CPT Codes
Both A and B
None of the above
Why is accurate medical coding important according to 'The Language of Billing: Medical Coding'?
Without accurate medical codes, insurance companies wouldn't know what services were performed and would be unable to process claims for payment.
Accurate medical coding helps doctors remember patient names.
Accurate medical coding is only used for research purposes.
Accurate medical coding is required to schedule patient appointments.
