Arkansas Life and Health Insurance Practice Exam

Which statement is false?

1. Mandatory Second Surgical Opinion is when the physician submits claim information prior to treatment, to determine in advance if the procedure is covered

2. Mandatory Second Surgical Opinion ensures that all surgeries are necessary

3. Mandatory Second Surgical Opinion can reduce unnecessary surgeries

4. Mandatory Second Surgical Opinion is generally required by the insurer

The correct answer is: Mandatory Second Surgical Opinion is when the physician submits claim information prior to treatment, to determine in advance if the procedure is covered

Mandatory Second Surgical Opinion is a process in which the physician is required to obtain a second opinion from another qualified physician prior to performing surgery, to ensure that the proposed procedure is necessary and appropriate. B and C are both correct statements because part of the purpose of Mandatory Second Surgical Opinion is to reduce unnecessary surgeries and ensure that surgeries are necessary. Option D may be true in certain cases but not necessarily for all insurers. However, option A is false because it states that the physician submits claim information to determine coverage, which is not part of the process of Mandatory Second Surgical Opinion.