CPB Certified Professional Biller Certification Practice Exam

Which term relates to insurance coverage and plans for medical services?

1. HRA

2. HMO

3. HIPAA

4. HICN

The correct answer is: HMO

The correct answer is related to Health Maintenance Organizations (HMO), which are a specific type of health insurance plan. HMOs provide coverage for a range of medical services through a network of providers and typically emphasize preventive care. Members of an HMO are usually required to choose a primary care physician and obtain referrals for specialist services, which helps control costs and ensures coordinated care. In contrast, the other terms provided do not specifically describe insurance coverage and plans in the same way. For instance, a Health Reimbursement Arrangement (HRA) is a type of employer-funded health benefit that can reimburse employees for their out-of-pocket medical expenses but does not function as a health insurance plan itself. HIPAA, or the Health Insurance Portability and Accountability Act, is legislation that provides privacy and security provisions for medical information but is not a type of insurance. Finally, the Health Insurance Claim Number (HICN) refers to a specific identification number used for processing claims, rather than a type of insurance or coverage plan.