PACS QUESTION BANK 2024/2025 COMPLETE
QUESTIONS WITH VERIFIED ANSWERS
GUARANTEED PASS | RATED A+
_______ processes are layers of testing that must be
... [Show More] done before others. - Answer>>> step
What is documented in the patient medical records? - Answer>>> • Laboratory and other studies
are ordered as appropriate
• Working diagnoses that are consistent with findings
• Treatment plans that are consistent with diagnosis
True or False: Biologics can be tiered to a lower tier that also contains other biologic products. -
Answer>>> True
What staff members are not involved in processing a medication prior authorization request at an
insurance company? Medical review officer, Pharmacist, Pharmacy technician, Veterinarian? -
Answer>>> Veterinarian
Information needed to verify insurance eligibility: - Answer>>> NPI number and insurance
policy identification number
Medical records may contain copies of: - Answer>>> flouroscopy and MRI
Authorizations are required: - Answer>>> • to save money
• to determine proper utilization of medical services
• to protect the patient
Medicaid is: - Answer>>> A coordination of health insurance benefits between the federal
government and state government
Most gap waivers cover the plan in network provisions of what is called the ______charges. -
Answer>>> customary
Locations in which patients might receive outpatient infusion: - Answer>>> • physician or
provider's office
• hospitals
• infusion centers
• home infusions
Evaluation & Management (E&M) coding - Answer>>> is defined as a process where a
physician-patient encounter or appointment is translated into CPT codes for billing purposes
Formulary exceptions are: - Answer>>> requests that are for medications on the plan formulary
but do not meet specific criteria
When writing an appeal letter, you should include: - Answer>>> • Your identification
• The reason for the denial that they explained in the denial letter
• The correct information
ICD-10 codes - Answer>>> Provide an alpha numeric reference for the diagnosis
If a gap waiver is approved, ___________________________ - Answer>>> Inform the patient,
physician and scheduler
A calendar year policy is from January 1 to December 31 - Answer>>> True
What is expected to happen as life expectancy trends upwards? - Answer>>> • higher medication
cost
• higher medication use
A PA request can take more than 3 days in order to hear an initial response. - Answer>>> True
Pharmacist, nurse, and medical assistants: - Answer>>> Are some of the healthcare personnels
who play the most important role in the PA process
A fast track for authorization is called _______. - Answer>>> urgent
Medigap coverage: - Answer>>> • medigap can be bought for any age person who is enrolled in
traditional medicare [Show Less]
