11. A form or phone call presented to the insurance company prior to a procedure being completed is called a(n): a.predetermination. b.authorization. c.treatment authorization. d.preauthorization. 12. Which of the following items is not required to obtain preauthorization for surgery? a.Insurance policy number b.Diagnosis related to reason for surgery c.List of potential complications d.Name of the surgeon 13. When an insurance company requires its approval prior to admission to the hospital for an elective surgery, this process is called: a.preauthorization. b.predetermination. c.authorization. d.precertification. 14. Predetermination requires the physician’s office to provide: a.a proposed treatment plan. b.a statement of the treatment provided. c.an invoice for the treatment provided. d.a request for authorization of a procedure. 15. When an insurance policy requires preauthorizations for procedures, it is a good idea for the medical biller to keep a: a.list of scheduled procedures. b.log of authorized procedures. c.list of codes related to procedures. d.list of authorized procedure codes. 16. The greater the insurance coverage, the greater the: a.payment. b.copayment. c.coinsurance. d.premium. 17. Which type of benefit is usually paid at 100 percent? a.Preventative services b.Comprehensive c.Major medical d.Basic 18. Use of a conversion factor allows the insurance company to: a.increase the deductible at regular intervals. b.vary the copayment for services. c.pay a small portion of services at 100 percent and others at varying amounts. d.confuse the physician’s office. 19. Accident benefits are the part of the insurance policy that: a.covers injuries incurred at work. b.covers car accidents. c.covers accidents or injuries that may have extraordinary costs. d.covers mistakes made in billing. 20. Accident benefits are usually: a.100 percent for anything related to the accident. b.time limited for a predetermined time period after the accident. c.unlimited. d.an 80 percent out-of-pocket expense for the patient.