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\n 1) Teeth Numbers #1-16 are a part of what arch? **
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1 point
\n
\n \n Maxillary Arch\n
\n Mandibular Arch
\n Buccal Arch
\n Lingual Arch
\n \n \n
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\n 2) Does the Primary Dentition consist of numbers or letters?*
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1 point
\n
\n \n Letters\n
\n Numbers
\n Both Letters & Numbers\n \n \n
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\n 3) The annual Maximum is the Total Amount that a plan will pay for Dental Coverage in a Calendar Year.*
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1 point
\n
\n \n True
\n False\n
\n \n \n
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\n 4) Insurance Policies can have what types of benefit timeframes?*
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1 point
\n
\n \n Calendar Year
\n Fiscal Year
\n Benefit Year
\n Month to Month
\n All of the above\n
\n \n \n
\n
\n 5) What does frequency/limitations mean for a dental insurance plan? *
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1 point
\n
\n It limits the number of times a service can be performed in a given time period\n
\n It is the time frame that a patient must wait before they can have a procedure completed
\n It is a procedure that is considered a non-covered benefit for the policy
\n It is considered an ineligible procedure and the patient has to pay out-of-pocket
\n It is considered an ineligible procedure and the office has to adjust fee\n \n
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\n 6) Why are intermediate (temp) restorations used in dentistry?*
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1 point
\n
\n \n Financial Reasons
\n To determine the health of the tooth
\n Waiting for Permanent Restoration
\n All of the above\n \n \n \n
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\n 7) Which of the following codes typically share a frequency?*
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1 point
\n
\n \n D4910
\n D1110
\n D1206
\n D1208
\n D1203
\n D4910 & D1110\n
\n D1206 & D1203
\n D1110 & D1206\n \n \n
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\n 8) What type of film allows the entire dentition to be viewed on a single film?*
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1 point
\n
\n \n Occlusal
\n Cephalometric
\n Panorex
\n All of the above\n \n \n
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\n 9) Which of the following x-rays typically share the frequency limitation?*
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1 point
\n
\n \n FMX
\n Pano
\n PA
\n BWX
\n FMX & Pano\n
\n FMX & BWX
\n Pano & PA\n \n \n
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\n 10) The following image is considered which type of x-ray*
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1 point
\n
\n
\n \n Cephalometric
\n BWX
\n Panorex\n
\n CT Scan\n \n \n
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\n 11) What is on the lower anterior teeth?*
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1 point
\n
\n
\n \n Bi-lateral Lower Spacer
\n Perio Splinting Bar
\n Lower Fixed Retainer\n
\n Removable Retainer\n \n \n
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\n 12) The above film is best sent to the Insurance Company when trying to get \"BLANK\" paid.*
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1 point
\n
\n
\n \n Extractions
\n Ortho
\n Bridge
\n All of the above\n \n \n \n
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\n 13) How many wisdom teeth are visible in the xray below?*
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1 point
\n
\n
\n \n 2
\n 4\n
\n 3
\n 0\n \n \n
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\n 14) Which type of dental radiograph shows 3D Images?*
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1 point
\n
\n \n CBCT/CT Scan\n
\n Panorex
\n Occlusal
\n BWX\n \n \n
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\n 15) Having Dual Insurance means the patient will not have an out-of-pocket expense.*
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1 point
\n
\n \n True
\n False\n \n \n \n
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\n 16) If both parents hold dental insurance for the children, how do you know which insurance is Primary?\n *
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1 point
\n
\n \n The parent that is older
\n The parent that had the insurance first
\n The parent who's birthday month is first in the Calendar year\n
\n The parent that has the better plan\n \n \n
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\n 17) When an insurance states they have a Missing Tooth Clause (MTC), this means:\n *
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1 point
\n
\n \n No coverage for any teeth extracted prior to the effective date\n
\n No coverage for the retainers
\n No coverage for the bridges
\n The patient has to wait 6 months before they will cover\n \n \n
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\n 18) What is considered required information for an insurance benefit breakdown?\n *
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1 point
\n
\n \n Group Number
\n Effective Date
\n Benefit Maximum
\n Payor ID
\n Frequency & Limitations
\n All of the above\n \n \n \n
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\n 19) In order to obtain the full insurance breakdown for a patient, you must have their SSN.\n *
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1 point
\n
\n \n True
\n False\n \n \n \n
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\n 20) Which statement below best describes \"the waiting period\" with an insurance plan?\n *
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1 point
\n
\n \n The Insurance will not pay benefits until the patient has paid their Premium
\n The Office must wait 30 days before starting treatment
\n The patient can choose to wait XXX days to get the treatment
\n The office must wait XXX days until the Insurance will cover a procedure\n \n \n \n
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\n 21) Primary and Secondary insurance are typically billed at the same time.\n *
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1 point
\n
\n \n True
\n False\n \n \n \n
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\n 22) When verifying insurance, what do frequencies typically mean?\n *
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1 point
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\n \n How often the patient should have the procedure done
\n How often the Insurance will pay for the procedure\n
\n The office cannot charge the patient if over the frequency
\n How often you may inquire on a patients benefits\n \n \n
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\n 23) Alternate (downgrade) benefit information is not necessary to gather when verifying insurance.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 24) It is important to verify whether the provider is in-network or out-of-network when verifying insurance plans for offices.\n *
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1 point
\n
\n \n True\n
\n False\n \n \n
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\n 25) The Subscriber of the Insurance can be different than the patient.\n *
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1 point
\n
\n \n True\n
\n False\n \n \n
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\n 26) If the patient has a Deductible, this applies to all procedures.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 27) All insurances pay a percentage of what the office has billed for the procedures.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 28) The Group Name is ALWAYS the patient's Employer.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 29) Which is the least efficient way of verifying a patient's Insurance\n *
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1 point
\n
\n \n Call the Insurance Company
\n Request a Fax back
\n Request a copy of the patients benefit booklet\n
\n Use the Insurance Portal\n \n \n
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\n 30) What is an Insurance Portal?\n *
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1 point
\n
\n \n A detailed booklet the insurance gives to the patient
\n A site the Insurance sets up for the patient to send their monthly premium
\n A site the Insurance sets up to research practice information
\n A site the Insurance sets up to research patient Insurance information and submit claims\n \n \n \n
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\n 31) Why is it important to verify a patient's Dental Insurance?\n *
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\n
\n \n Federal and State require this of all offices who participate with Dental Plans
\n Insurance companies require this
\n The office will be fined if they do not follow this policy
\n It helps estimate the patients co-payments and co-insurance for the appointments\n \n \n \n
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\n 32) Most insurances have an Individual Deductible and a Family Deductible.\n *
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\n
\n \n True\n
\n False\n\n \n \n
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\n 33) If the Insurance portal does not have all of the information needed for the breakdown, what would your next step be?\n *
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\n \n Call the office
\n Call the Insurance\n
\n Request a Fax
\n If the Portal does not have the information, it is not available.\n \n \n
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\n 34) Most Dental Insurances cover both intermediate and permanent dentures.\n *
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\n
\n \n True
\n False\n
\n \n \n
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\n 35) Which one of the following is not typically considered a “Dental Category”?\n *
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\n \n Preventative
\n Major
\n Medical\n
\n Basic\n \n \n
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\n 36) When verifying Insurance, it is important to gather ___________ from the Insurance\n for future reference? (Select all that apply)\n *
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1 point
\n
\n The representative’s name
\n The Date of the Call
\n A reference number
\n All of the above\n \n \n
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\n 37) When verifying Insurance, which information is NOT necessary to retrieve the data you are requesting? (Select all that apply)\n *
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\n
\n The Patient's name and DOB
\n The patient's sex\n
\n The Office information
\n The Subscriber name, ID number and DOB
\n The patient's employer\n
\n The home address for the patient\n
\n All of the above\n \n
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\n 38) If an insurance plan is already entered into the Practice Software, it is NOT necessary to verify the patient's coverage.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 39) The reason we verify a patient's dental insurance is so we can guarantee payment from the insurance company.\n *
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1 point
\n
\n \n True
\n False\n \n \n \n
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\n 40) Verifying specific codes is sometimes necessary to determine coverage as there are\n many non-covered procedures within the specific categories of coverage.\n *
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\n
\n \n True\n
\n False\n \n \n
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\n 41) Delta Dental has one Corporate Office and one phone number that accepts all calls\n for any Delta plan, regardless of the State.\n *
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\n
\n \n True
\n False\n \n \n \n
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\n 42) HIPAA stands for:\n *
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\n \n Health Insurance Profitability and Accountability
\n Home Individual Profits and Ascension
\n Health Insurance Portability and Accountability Act\n
\n Health Individual Profits and Accounts\n \n \n
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\n 43) It is NOT necessary to verify Orthodontic Benefits if you are calling for a General Dental Office.\n *
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1 point
\n
\n \n True
\n False\n
\n \n \n
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\n 44) What is the Payor ID for this Carrier?\n *
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1 point
\n
\n
\n 0302280
\n 0019
\n 65978\n
\n 6383379
\n \n
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\n 45) Does this plan have a MTC (Missing Tooth Clause)?\n *
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1 point
\n
\n
\n \n Yes
\n No\n
\n Maybe\n \n \n
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\n 46) Based on this image, if the patient's appointment is 03/17/2019, is the patient eligible\n for an FMX?\n *
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1 point
\n
\n
\n \n Yes\n
\n No
\n Maybe\n \n \n
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\n 47) Based on the image above, what statement is true.\n *
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1 point
\n
\n
\n \n The patient can have an Exam done 1 time in 6 months
\n The patient can have an Exam done 2 times, anytime during the Calendar Year\n
\n The patient can have an Exam done 1 time + 1 day in 6 months
\n The patient does not have a frequency for the Limited Exams\n \n \n
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\n 48) Looking at this image, what type of insurance plan does this patient have?\n *
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1 point
\n
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\n \n DMO\n
\n PPO
\n Medical
\n Indemnity\n \n \n
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\n 49) Based on this image, is the patient eligible for a PANOREX for DOS: 1/20/2020?\n *
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1 point
\n
\n
\n \n Yes
\n No\n
\n Maybe\n \n \n
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\n 50) Using the image below, Are the Preventive Services subject to just the deductible,\n just the maximum or both the deductible and the maximum?\n *
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\n \n Neither Deductible or Maximum\n
\n Just the Deductible
\n Just the Maximum
\n Both the Deductible & the Maximum\n \n \n
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\n 51) Based on the image below, do all exams share the frequency?\n *
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1 point
\n
\n
\n \n Yes
\n No\n
\n Maybe\n \n \n
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\n 52) Based on the image below, does this plan have a missing tooth clause (MTC)?\n *
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1 point
\n
\n
\n \n Yes\n
\n No
\n Maybe\n \n \n
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\n 53) Based on the image below, when is the patient eligible for Fluoride?\n *
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1 point
\n
\n
\n \n 09/12/2019
\n 09/13/2019\n
\n 09/01/2019
\n 09/06/2019\n \n \n
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\n 54) Based on the image below, what is the individual Yearly Maximum?\n *
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1 point
\n
\n
\n \n $1000
\n $1500\n
\n $150
\n $50\n \n \n
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\n 55) Based on the image below, the patient has used how much of their maximum?\n *
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1 point
\n
\n
\n \n $96\n
\n $0
\n $50
\n $86\n \n \n
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\n 56) Based on the image below, what is the patient's Family Deductible?\n *
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1 point
\n
\n
\n \n $100
\n $50
\n $150\n
\n $1000\n \n \n
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\n 57) Based on the image below, does this plan downgrade composites on molars?\n *
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1 point
\n
\n
\n \n Yes\n
\n No
\n Maybe\n \n \n
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\n 58) Based on the image below, does this plan downgrade D2740 for molar teeth?\n *
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1 point
\n
\n
\n \n Yes\n
\n No
\n Maybe\n \n \n
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\n 59) Based on the image below, does this plan downgrade D2740 on premolars?\n *
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1 point
\n
\n
\n \n Yes
\n No\n
\n Maybe\n \n \n
\n
\n 60) Based on the image below, are ALL prosthetics paid on the seat/delivery date?\n *
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1 point
\n
\n
\n \n Yes\n
\n No
\n Maybe\n \n \n
\n
\n 61) Based on the image below, what is the COB (Coordination of benefits) for this plan?\n *
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1 point
\n
\n
\n \n Non-Duplication
\n Standard\n
\n Carve-out plan
\n Maintenance of benefits\n \n \n
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\n 62) What is the most important piece of information needed from this section of the\n verification form to secure before you hang up with a representative?\n *
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1 point
\n
\n
\n \n Payor ID
\n Call reference number and Insurance rep name\n
\n Insurance Company Address
\n Group Name\n \n \n
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\n 63) Based on the image below, the member has all of their Calendar Year Maximum remaining.\n *
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1 point
\n
\n
\n \n True
\n False\n \n \n \n
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\n 64) Based on the image below, What is the Group Number?\n *
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1 point
\n
\n
\n \n U10371298
\n 3174776\n \n \n \n
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\n 65) Based on the image below. What is the Orthodontic Maximum?\n *
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1 point
\n
\n
\n \n $2,000 Calendar Year
\n $2,500 Calendar Year
\n $2,000 Lifetime
\n $2,500 Lifetime\n \n \n \n
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\n 66) What does the following statement mean from the image below?\n *
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1 point
\n
\n
\n \n All fillings are covered at the same percentage amount.
\n Certain fillings may be covered at a different rate.
\n Fillings require a predetermination.
\n Composite fillings will be downgraded to the amalgam rate.\n \n \n \n
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\n 67) Based on these images, is the verification form filled out correctly?\n *
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1 point
\n
\n
\n \n Yes- All are correct
\n No- 1 place is wrong
\n No- 2 places are wrong\n
\n No- 3 places are wrong\n \n \n
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\n 68) After reviewing the faxback and completed section of the verification form- what edits\n are needed before considering this entry complete and accurate?\n *
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1 point
\n
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\n \n No corrections need to be made\n
\n Major percentage needs corrected to 90%
\n The deductible is not waived on preventive services
\n Composite frequency is 1/12mo\n \n \n
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\n 69) Patient S. Smith called and scheduled for an exam on 12/10/2019- Her last exam was\n 1/15/2019 and she had her six month exam on 6/12/19. Based on the image, will her insurance\n benefits cover her appointment in December?\n *
\n
1 point
\n
\n
\n \n Yes
\n No\n
\n Maybe\n \n \n
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\n 70) Please review the completed verification form below: How many items are needed before\n this Verification can be considered complete and accurate?\n *
\n
1 point
\n
\n
\n \n 5\n
\n 6
\n 7
\n 8\n \n \n
\n Submit\n Cancel\n
\n