H08V EXAM 5 ANSWERS - ASHWORTH

H08V EXAM 5 ANSWERS - ASHWORTH

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H08V Medical Coding II Exam 5 Answers (Ashworth)
Question 21

2.5 / 2.5 points
An active-duty military member has TRICARE. Under the program, this person is called the
Question options:
a) 
insured.

b) 
TPR.

c) 
DEERS.

d) 
sponsor.

Question 22

2.5 / 2.5 points
Which one of the following choices processes all claims for TFL?
Question options:
a) 
CHAMPUS

b) 
CMS

c) 
TRICARE

d) 
WPS

Question 23

2.5 / 2.5 points
A mother and child are both covered under the father’s TRICARE insurance. What should be entered on form locator 1a for the claim form?
Question options:
a) 
The child’s Social Security number

b) 
The father’s Social Security number

c) 
The mother’s Social Security number

d) 
Nothing

Question 24

0 / 2.5 points
Which of the following services is covered under TRICARE Standard?
Question options:
a) 
Chiropractic care

b) 
Cosmetic surgery

c) 
Mental health care

d) 
Custodial care

Question 25

0 / 2.5 points
The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for active-duty families is
Question options:
a) 
$1,000 per beneficiary.

b) 
$3,000 per family.

c) 
$3,000 per beneficiary.

d) 
$7,500 per family.

Question 26

2.5 / 2.5 points
The TRICARE health maintenance organization (HMO) plan option is
Question options:
a) 
TRICARE Standard.

b) 
TRICARE Extra.

c) 
TRICARE Prime.

d) 
CHAMPVA.

Question 27

2.5 / 2.5 points
On the “Medicaid Resubmission Code” form locator, what should be entered when filing a TRICARE claim?
Question options:
a) 
“X”

b) 
“Y” or “N”

c) 
The provider ID number

d) 
Nothing

Question 28

0 / 2.5 points
When a TRICARE beneficiary needs treatment that is not available from a military treatment facility (MTF), what happens?
Question options:
a) 
The beneficiary will have to pay for the services.

b) 
The services will be covered at a lower rate.

c) 
The beneficiary must obtain a nonavailability statement to receive services from a civilian provider.

d) 
The beneficiary can automatically receive services from a civilian provider.

Question 29

2.5 / 2.5 points
Which one of the following choices assists veterans who have service-related disabilities?
Question options:
a) 
CHAMPUS

b) 
TFL

c) 
CHAMPVA

d) 
MTF

Question 30

2.5 / 2.5 points
Review the completed claim form (Figure 14.3) on page 423 of your textbook. Who is the patient receiving coverage through?
Question options:
a) 
TRICARE

b) 
Marines

c) 
COOBA

d) 
Charles H. Borden

Question 31

2.5 / 2.5 points
Under TRICARE Standard, which group of beneficiaries pays 15% cost share for in-network outpatient services?
Question options:
a) 
Former spouses of active-duty service members

b) 
Families of active-duty service members

c) 
Families of deceased personnel

d) 
Retirees from the military

Question 32

2.5 / 2.5 points
Which one of the following choices is the DOD medical entitlement program?
Question options:
a) 
TRICARE

b) 
PCCM

c) 
MTF

d) 
DEERS

Question 33

2.5 / 2.5 points
Review the completed TRICARE claim form (Figure 14.3) on page 423 of your textbook. What was the disease or illness code that brought the patient in for treatment?
Question options:
a) 
99213

b) 
J11.1

c) 
12345

d) 
85.00

Question 34

0 / 2.5 points
A physician wants to start seeing TRICARE patients. What is it important for the physician to remember?
Question options:
a) 
Only sponsors can receive benefits.

b) 
The physician must be medically certified by the AMA to see military personnel.

c) 
Claims must be filed within 30 days from the time the patient is seen in the office.

d) 
TRICARE must be listed with the DRG first.

Question 35

2.5 / 2.5 points
Which one of the following choices assigns a person to help coordinate and manage a patient’s medical care?
Question options:
a) 
TRICARE Standard

b) 
TRICARE Prime

c) 
TRICARE Prime Remote

d) 
TRICARE Extra

Question 36

2.5 / 2.5 points
Which one of the following choices is used for permanent military personnel who aren’t near any treatment facilities?
Question options:
a) 
TRS

b) 
TFL

c) 
TPR

d) 
TYA

Question 37

2.5 / 2.5 points
An individual who qualifies for TRICARE is known as a(n)
Question options:
a) 
member.

b) 
beneficiary.

c) 
sponsor.

d) 
enrollee.

Question 38

2.5 / 2.5 points
A TRICARE patient sees a chiropractor on a weekly basis for an injury. Which of the following statements is true about financial responsibility for the charges?
Question options:
a) 
The entire bill will be paid by TRICARE.

b) 
The patient will probably be responsible for the entire bill.

c) 
The patient may be responsible for 80 percent of the bill.

d) 
The patient may be responsible for 20 percent of the bill.

Question 39

2.5 / 2.5 points
Authorized TRICARE providers include all of the following except
Question options:
a) 
chiropractors.

b) 
doctors of dental medicine.

c) 
doctors of optometry.

d) 
psychologists.

Question 40

2.5 / 2.5 points
A TRICARE patient needs to be treated at a civilian facility because of the specialized treatment provided there. What’s the patient’sfirst step?
Question options:
a) 
Receive a NAS.

b) 
Check with the DEERS.

c) 
Request prospective reimbursement information from the HCF.

d) 
Find the nearest MTF for 100% reimbursement coverage.


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