Free Medical Plans Practice Questions
New York Life, Accident & Health exam (series 17-55) — 55 practice questions.
Subtopics: Prompt pay, Prompt pay paper claims, External appeal timing, Expedited external appeal, External appeal cost, Utilization review timing, Internal appeal window, Specialist as coordinator, Out-of-network referral, Maternity home visit, Mammography, IVF cycles, Mental health providers, Healthy NY, Healthy NY participation, Healthy NY prior coverage, Marketplace, Child Health Plus, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Capitation, Precertification, Basic hospital expense, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, Preventive care, Special enrollment, HDHP and HSA, Managed care, Usual, reasonable and customary, Basic surgical, Short-term medical, Vision insurance
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Sample questions & answers
1. Under New York's prompt pay law, an insurer must pay an undisputed health claim submitted electronically within:
30 days of receipt
Clear claims must be paid within 30 days if submitted electronically or 45 days if submitted on paper or by fax.
2. An undisputed health claim submitted to a New York insurer on paper must be paid within:
45 days of receipt
Paper or fax claims must be paid within 45 days of receipt (30 days for electronic claims).
3. A New York external appeal agent must decide a standard external appeal within:
30 days of receiving the request
Standard external appeals are decided within 30 days; expedited appeals within 72 hours.
4. When a delay would seriously threaten the insured's health, a New York external appeal must be completed within:
72 hours
Expedited external appeals must be completed within no more than 72 hours of the request.
All Life, Accident & Health topics
Practice: Medical Plans
Answer choices are shuffled every time, and every question comes with an explanation.
Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
