Homework Answers
1 )Option'.C
Third party administrator.
TPA acts as intermediate between two organisations.And it administrates services for other companies.
2)Option D.
All of the above.
Affordable Care Act includes emergency services, labarotory services, prescription drugs.
3)Option C.
Medically necessary.
4)Option B.
Preventive services.
5)Option A.
Part A.
6)Option A.
Fee schedule.
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TUU UI WC dove An organization that processes claims and provides administrative services for another organization...
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b....
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b. resource-based relative value system. third-party administrator. d. provider network. a. C. 37. The Affordable Care Act includes which of the following categories of essential health benefins a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. 39....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b. resource-based relative value system. c. third-party administrator. d. provider network. 37. The Affordable Care Act includes which of the following categories of essential health benefits? a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. Service provided...
QUESTION 17 Match to term to the correct definition A. publication where GAAP is presented for...
QUESTION 17 Match to term to the correct definition A. publication where GAAP is presented for the health care industry applies to investor-owned, for-profit organizations, created expanded duty for B. the governing board in the performance of its fiduciary duties (financial reporting) ca uniform method used by CMS for health care providers and medical suppliers to code for professional services, procedures and supplies - Audit and Accounting Guide for Health Care Organizations (AAG-HCO) Sarbanes-Oxley Act (SOX) Healthcare Common Procedure Coding...
A Health Maintenance Organization (HMO) is a type of health insurance plan that a. You will...
A Health Maintenance Organization (HMO) is a type of health insurance plan that a. You will receive most or all of your care through a provider network b. You must choose a PCP c. Covers care both inside and outside the plans provider network d. a and b
69) A policy that pays you back for actual expenses is called A) An indemnity plan....
69) A policy that pays you back for actual expenses is called A) An indemnity plan. B) A deductible plan. C) A reasonable and customary plan. D) A reimbursement plan. E) A coinsurance plan m The set amount that you must pay toward medical expenses before the insurance company pays benefits is called A) Deductible. B) Reimbursement C) Indemnity. D) Internal limit. E) Reasonable and customary charges. 71) Which of the following is a government health care program? A) Health...
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not...
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not rendered. C. Billing for services not medically indicated or necessary D. Physician billing for services provided by interns and residents. E. Giving health care providers inducements in exchange for referrals. C Lawsuits filed by private individuals under the False Claims Act are referred to as actions. C A. All of the above. B. Whistleblower C C. Relator C D. Qui Tam The Medicare Program:...
UESTION 5 Match the following government insurance with its purpose. Provides prescription drug benefits to seniors...
UESTION 5 Match the following government insurance with its purpose. Provides prescription drug benefits to seniors and other eligible beneficiaries. A. Medicare -A Coverage for inpatient hospital care, skilled nursing care, hospice, and home health care B. Medicare -B Medicare -C Eliminates the need for supplemental Medigap insurance because deductibles and coinsurance costs are nonexistent. D. Medicare -D Coverage for physician charges, outpatient hospital services, ambulance services, and emergency department services. lick Save and Submit to save and submit. Click...
23. NAMI (National alliance for the mentally II) is a d professional organization for the mental...
23. NAMI (National alliance for the mentally II) is a d professional organization for the mental health professionals b. advocacy group for the mentally ill factor that contributed siknificantly to deinstitutionalization of mentallyill atients was: a. The development of effective pharmacologic treatments b. Rising concern over the costs of inpatient care c. The Quaker movement for "moral treatment" 24. One reason why only a small percentage of those in need of mental health services actually receives them is: Mental health...
4. KEY TERMS Multiple Choice Circle the letter of the choice that best matches the definition...
4. KEY TERMS Multiple Choice Circle the letter of the choice that best matches the definition or answers the question 1. A list of the medical services covered by an insurance policy C. Noncovered services D. Fee-for-service A. Health care claim B. Schedule of benefits 2. Health plans are often referred to as: C. Providers D. Payers A. Policyholders B. Subscribers managed care network of providers under contract to provide services at discounted fees. A. Health Maintenance Organization (HMO) B....
M U T a le Te Urus compromised for all reported breaches affecting 500 individuals or...
M U T a le Te Urus compromised for all reported breaches affecting 500 individuals or more has risen. Chapter 1 Review Exercises 1. In 1965, what programs were developed making the US government the largest payer of healthcare services? a. Medicare and Tricare wollen dood b. Medicare and Medicaid c. Medicaid and Bureau of Workers' Compensation d. Medicare and Bureau of Workers' Compensation 2. Which federal legislation requires US citizens to have health insurance coverage? a. Health Insurance Portability...
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b. resource-based relative value system. third-party administrator. d. provider network. a. C. 37. The Affordable Care Act includes which of the following categories of essential health benefins a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. 39....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b. resource-based relative value system. c. third-party administrator. d. provider network. 37. The Affordable Care Act includes which of the following categories of essential health benefits? a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. Service provided...
QUESTION 17 Match to term to the correct definition A. publication where GAAP is presented for the health care industry applies to investor-owned, for-profit organizations, created expanded duty for B. the governing board in the performance of its fiduciary duties (financial reporting) ca uniform method used by CMS for health care providers and medical suppliers to code for professional services, procedures and supplies - Audit and Accounting Guide for Health Care Organizations (AAG-HCO) Sarbanes-Oxley Act (SOX) Healthcare Common Procedure Coding...
69) A policy that pays you back for actual expenses is called A) An indemnity plan. B) A deductible plan. C) A reasonable and customary plan. D) A reimbursement plan. E) A coinsurance plan m The set amount that you must pay toward medical expenses before the insurance company pays benefits is called A) Deductible. B) Reimbursement C) Indemnity. D) Internal limit. E) Reasonable and customary charges. 71) Which of the following is a government health care program? A) Health...
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not rendered. C. Billing for services not medically indicated or necessary D. Physician billing for services provided by interns and residents. E. Giving health care providers inducements in exchange for referrals. C Lawsuits filed by private individuals under the False Claims Act are referred to as actions. C A. All of the above. B. Whistleblower C C. Relator C D. Qui Tam The Medicare Program:...
UESTION 5 Match the following government insurance with its purpose. Provides prescription drug benefits to seniors and other eligible beneficiaries. A. Medicare -A Coverage for inpatient hospital care, skilled nursing care, hospice, and home health care B. Medicare -B Medicare -C Eliminates the need for supplemental Medigap insurance because deductibles and coinsurance costs are nonexistent. D. Medicare -D Coverage for physician charges, outpatient hospital services, ambulance services, and emergency department services. lick Save and Submit to save and submit. Click...
23. NAMI (National alliance for the mentally II) is a d professional organization for the mental health professionals b. advocacy group for the mentally ill factor that contributed siknificantly to deinstitutionalization of mentallyill atients was: a. The development of effective pharmacologic treatments b. Rising concern over the costs of inpatient care c. The Quaker movement for "moral treatment" 24. One reason why only a small percentage of those in need of mental health services actually receives them is: Mental health...
4. KEY TERMS Multiple Choice Circle the letter of the choice that best matches the definition or answers the question 1. A list of the medical services covered by an insurance policy C. Noncovered services D. Fee-for-service A. Health care claim B. Schedule of benefits 2. Health plans are often referred to as: C. Providers D. Payers A. Policyholders B. Subscribers managed care network of providers under contract to provide services at discounted fees. A. Health Maintenance Organization (HMO) B....
M U T a le Te Urus compromised for all reported breaches affecting 500 individuals or more has risen. Chapter 1 Review Exercises 1. In 1965, what programs were developed making the US government the largest payer of healthcare services? a. Medicare and Tricare wollen dood b. Medicare and Medicaid c. Medicaid and Bureau of Workers' Compensation d. Medicare and Bureau of Workers' Compensation 2. Which federal legislation requires US citizens to have health insurance coverage? a. Health Insurance Portability...
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