Certified Medical Assistant Practice Exam

What does non-duplication of benefits mean?

1. Two insurance companies will pay the same claim twice

2. Insurance benefits will not be provided for the same condition

3. Benefits will be coordinated between two separate insurance companies

4. The patient will receive duplicate insurance cards

The correct answer is: Benefits will be coordinated between two separate insurance companies

Non-duplication of benefits refers to the process where benefits from two separate insurance plans are coordinated to prevent the payment of claims for the same expenses by both insurers. This ensures that the total amount paid does not exceed the actual incurred costs and that patients do not receive excess payments for the same medical treatment. It allows for a system where patients can benefit from multiple insurance sources without duplicating the coverage for the same services, helping to mitigate costs and streamline the claims process. The other options do not accurately capture the essence of non-duplication of benefits. For instance, a scenario where two insurance companies pay the same claim twice contradicts the purpose of non-duplication. Additionally, stating that insurance benefits will not be provided for the same condition suggests a lack of coverage that does not align with the concept of coordinating benefits. Lastly, the mention of duplicate insurance cards is unrelated to the financial aspect of benefits coordination.