Claims Associate

Claims Associate Interview Questions and Answers for Freshers

Updated 23 Feb 2024
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Q1. What is the difference between Medicare and Medicaid

Ans.

Medicare and Medicaid are both government healthcare programs in the United States, but they serve different populations and have different eligibility criteria.

  • Medicare is a federal health insurance program primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities.

  • Medicaid is a joint federal and state program that provides health coverage to low-income individuals and families, including pregnant women, children, and people with di...read more

Q2. What are the Managed care plans?

Ans.

Managed care plans are healthcare plans that aim to control costs and improve quality by coordinating medical services.

  • Managed care plans involve a network of healthcare providers who agree to provide services at reduced rates.

  • These plans typically require members to choose a primary care physician who coordinates their care and provides referrals to specialists.

  • Common types of managed care plans include Health Maintenance Organizations (HMOs), Preferred Provider Organization...read more

Q3. what is legato,what is insurance

Ans.

Legato is a term used in music to describe smooth and connected notes. Insurance is a contract between an individual or organization and an insurance company to provide financial protection against potential losses.

  • Legato refers to playing or singing notes smoothly and without interruption.

  • In insurance, individuals or organizations pay premiums to an insurance company in exchange for coverage against potential risks or losses.

  • Insurance policies can cover various aspects such ...read more

Q4. What is CHAMPVA?

Ans.

CHAMPVA is a healthcare program for eligible dependents of veterans, providing coverage for medical services and prescriptions.

  • CHAMPVA stands for Civilian Health and Medical Program of the Department of Veterans Affairs.

  • It is a comprehensive healthcare program for the dependents of veterans who are not eligible for TRICARE.

  • CHAMPVA covers a wide range of medical services, including doctor visits, hospital stays, mental health services, and prescription medications.

  • Eligible dep...read more

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Q5. Explain What is Copay

Ans.

A copay is a fixed amount that an insured person pays for a covered healthcare service at the time of receiving the service.

  • Copay is a form of cost-sharing between the insurance company and the insured individual.

  • It is a predetermined amount that the insured person must pay out of pocket for each visit or service.

  • Copayments can vary depending on the type of service, such as doctor visits, prescription drugs, or specialist consultations.

  • For example, a health insurance plan may...read more

Q6. Whats is HIPPA

Ans.

HIPAA (Health Insurance Portability and Accountability Act) is a US law that protects the privacy and security of patients' health information.

  • HIPAA is an acronym for Health Insurance Portability and Accountability Act.

  • It was enacted in 1996 to establish national standards for the protection of individuals' medical records and other personal health information.

  • HIPAA applies to healthcare providers, health plans, and healthcare clearinghouses that transmit health information e...read more

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Q7. solve 30%1800

Ans.

The answer is 540.

  • To solve 30% of 1800, multiply 30/100 by 1800.

  • 30/100 x 1800 = 540

Q8. How replace fender

Ans.

To replace a fender, you will need to remove the damaged fender, prepare the new fender for installation, and then install the new fender onto the vehicle.

  • Remove the damaged fender by unbolting it from the vehicle

  • Prepare the new fender by painting it to match the vehicle's color if necessary

  • Install the new fender onto the vehicle by bolting it into place

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