1) What is the rule used to determine whose insurance is primary for a child that is covered under both parents' insurance? a) Rule of Ages b) Birthday Rule c) Oldest Parent Rule d) Primary Insurance Rule 2) What types of plans are referred to as the insurance of last resort? a) Medicare and Medicare Advantage Plans b) State Programs c) MA and MA HMO Plans d) Commercial and Group Health Plans 3) What type of insurance will always be loaded secondary to Medicare? a) Commercial Plan b) Auto and Worker's Comp c) Medicare Advantage Plan d) Medicare Supplement 4) What types of plans are considered the payer of last resort after Medical Assistance? a) State Programs b) Government Research Programs c) Auto and Worker' Comp d) Department of Veteran's Affairs 5) What is the COB for a patient who is covered by Capital Blue but is also covered by their spouse's Highmark Blue Shield insurance? a) Capital Blue Only b) Capital Blue primary and Highmark Blue Shield secondary c) Highmark Blue Shield Only d) Highmark Blue Shield Primary and Capital Blue Secondary 6) Auto or Worker's Comp plans are loaded in what COB order with a patient's health insurance? a) Auto or Worker's Comp primary followed by the patient's health insurance secondary b) Patient's health insurance primary followed by Auto or Worker's Comp 7) A patient is 70 and retired with Medicare. They are also covered by their working spouse's Cigna Insurance. The spouse's work has 90 employees. What is the COB? a) Medicare primary and Cigna secondary b) Medicare Only c) Cigna primary and Medicare secondary d) Cigna Only 8) Which health plan does not follow the birthday rule? a) Capital Blue Cross b) Medical Assistance c) Medicare d) Tricare 9) A child is covered by his mother's insurance, BC Independence. Mom's birthday is 09/10/70. The child is also covered by his father's Tricare. Dad's birthday is 01/10/70. What is the COB? a) Tricare primary and BC Independence secondary b) BC Independence primary and Tricare secondary c) Tricare Only d) BC Independence Only 10) A patient is being seen for an auto accident and they have an auto claim. The patient also hands you a Medical Assistance card and a Highmark Wholecare Medicaid Gateway card. What is the COB? a) Auto primary and PA Medical Assistance Secondary b) Highmark Wholecare Medicaid Gateway primary and Auto secondary c) Auto primary and Highmark Wholecare Medicaid Gateway secondary d) Auto primary, Highmark Wholecare Medicaid Gateway secondary, PA Medical Assistance tertiary 11) A 72 year old patient presents a Humana Gold card, a Medicare card, and a Amerihealth Caritas Community Health Choices card. What is the COB? a) Amerihealth Caritas Community Health Choices primary and Medicare secondary b) Amerihealth Caritas Community Health Choices primary and Humana Gold secondary c) Humana Gold primary, Medicare secondary, and Amerihealth Community Health Choices tertiary d) Humana Gold primary and Amerihealth Caritas Community Health Choices secondary 12) A patient was referred by the VA. He is 75 and has Medicare, Highmark Supplemental, and VA coverage. What is the COB? a) Medicare primary, Highmark Supplemental secondary, and VA coverage tertiary b) VA coverage primary, Medicare secondary, and Highmark Supplemental tertiary c) Medicare primary, VA coverage secondary, Highmark Supplemental tertiary d) VA coverage primary, Highmark Supplemental secondary, Medicare tertiary 13) A child has Geisinger coverage through her father's work, her father's DOB is 08/20/78. The child also has Humana coverage through her mother's work, her mother's DOB is 02/15/80. What is the COB? a) Geisinger primary and Humana secondary b) Geisinger Only c) Humana primary and Geisinger secondary d) Humana Only 14) A patient is being treated for a work injury. They also hand you a Blue Journey card and a Medicare card. What is the COB? a) Workers Comp primary and Blue Journey secondary b) Workers Comp primary and Medicare secondary c) Medicare primary and Blue Journey secondary d) Blue Journey primary and Worker's Comp secondary 15) A patient is 66 with Medicare but also has United Healthcare through their work at a local furniture shop that has 12 employees. What is the COB? a) United Healthcare Only b) Medicare Only c) United Healthcare primary and Medicare secondary d) Medicare primary and United Healthcare secondary 16) A child has the State Renal Program. They also have Aetna Better Health as well as Highmark coverage, through their father's work. What is the COB? a) Highmark primary, State Renal Program secondary, Highmark tertiary b) Highmark primary, Aetna Better Health secondary, and State Renal Program tertiary c) State Renal Program primary, Aetna Better Health secondary, Highmark tertiary d) Aetna Better Health primary, Highmark secondary, State Renal Program tertiary 17) A child is covered by both of their parents' GHP plans through their employers. Mom’s birthday is 07/04/70 and she has Highmark PPO Blue and Dad's birthday is 10/20/68 and he has Capital Blue Cross. The child also has UPMC for you. What is the correct COB? a) Capital Blue primary, Highmark Secondary, UPMC for you tertiary b) Highmark primary, Capital Blue secondary, and UPMC for you tertiary c) UPMC for you primary, Highmark secondary, Capital Blue Cross tertiary d) Highmark primary, Capital Blue Cross secondary 18) If you see this listed on an auto insurance claim, you know to not use it. a) AUTOOVER b) NOAUTO c) CLAIMNA d) AUTOMAX 19) A 30 year old patient has Medicare due to disability. They also have Aetna coverage through their spouse's work at Target. What would be the correct COB? a) Aetna primary and Medicare secondary b) Medicare primary and Aetna secondary c) Medicare Only d) Aetna Only 20) An ESRD Medicare patient is currently on dialysis and they have Aetna coverage through their current employer. What is the COB after the 30 month coordination period? a) Aetna only b) Medicare only c) Medicare primary and Aetna secondary d) Aetna primary and Medicare secondary

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