Federal preemptions under ERISA, HIPPA, and /or the ACA apply to all but which of the...
Federal preemptions under ERISA, HIPPA, and /or the ACA apply to all but which of the following? a. Insured Health plans and HMO's b. Self-funded health benefits plans c. Provider payment d. Appeal and Grievance Rights e. Health care privacy rights f. Electronic transactions and code sets
Homework Answers
Option b)
All of these regulates in self funded health benefits are applied to all of these including all HIPPA , ERISA and ACA
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Federal preemptions under ERISA, HIPPA, and /or the ACA apply to
all but which of the...
Someone post from a discussion question... (Respond to it) Medicare is a federal program that provides...
Someone post from a discussion question... (Respond to it) Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income. Medicaid offers care to the poorest families while CHIP extends coverage to a larger number of children. Care through the Medicaid program may be more extensive, but the CHIP...
When it comes to billing and collection issues, some of the main rules that physician billers...
When it comes to billing and collection issues, some of the main rules that physician billers and biller services must follow are (Ch 9) determination of patient third-party status, amount of copayment that needs to be collected from the patient, correct coding, coordination of benefits, preauthoritzation of services, referral, second opinion, fraud and abuse regulations O collection of deductible, timely coding, fraud and abuse regulations, provider credential verification, second option, income verification, coordination of benefits o preauthorization of services, access...
3. Match the financial classes in the first column to their definitions in the second column....
3. Match the financial classes in the first column to their definitions in the second column. Commercial insurance A. Countrywide health program for certain people and families with low income and resources. It is jointly funded by the Guarantor federal government and the individual states and is run by Medicaid each individual state. Workers compensation B. Includes all of the insurance companies who provide coverage Employee health to employers for when their employees are injured while working. Medicare C. Includes...
20. Identify the federal law which promoted employer benefit programs and has been...
20. Identify the federal law which promoted employer benefit programs and has been found to prohibit state law claims ( such as malpractice and negligence claims) against insurance companies that are part of an employer sponsored health plan. 21. Identify three resources that providers can use to determine the scope of Medicare coverage for a particular service? 22. What is a QIO? 23. What is the statutory legal standard under the federal Anti-kickback Statute? a. Malice aforethought b....
1. What are the three major payer categories? A. Personal health B. Employee health C. Family...
1. What are the three major payer categories? A. Personal health B. Employee health C. Family health D. Workers compensation E. National health F. Group health 2. Which of the following pays the highest rates for healthcare services? A. Commercial health insurance B. Medicaid C. Self pay patients D. Medicare E. Guarantors of patients 3. Match the financial classes in the first column to their definitions in the second column. _Commercial insurance A. Countrywide health program for certain people and...
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....
KEY TERMS to hog ho MATCHING Match the definition with the correct term from the following...
KEY TERMS to hog ho MATCHING Match the definition with the correct term from the following word list. A. administrative code set B. billing provider C. carrier block D. claim attachment E claim control number claim filing indicator code G. claim frequency code (claim submission eason code) H. claim soruhter I clean claims Q. HIPAA XI2 837 Healh Care Claim Professional (R37P) R. line item conl nember S. National Uniform Claim Committee (NUCC) T. other ID nunber U. ostside lahoratory...
read below and answer the question at the end HUMAN PARTICIPANTS AND ANIMAL SUBJECTS IN RESEARCH...
read below and answer the question at the end HUMAN PARTICIPANTS AND ANIMAL SUBJECTS IN RESEARCH Any scientist who conducts research with human participants needs to protect the interest of research subjects by complying with federal, state, and local regulations and with relevant codes established by professional groups. These provisions are designed to ensure that risks to human participants are minimized; that risks are reasonable given the expected benefits; that the participants or their authorized representatives provide informed consent; that...
46. Which situation(s) are classified as natural disasters? Select all that apply. a. Blizzards b. Terrorist...
46. Which situation(s) are classified as natural disasters? Select all that apply. a. Blizzards b. Terrorist attacks e. Volcanic eruptions d. Structural collapse e. Communicable diseases 47. The nurse employed in a mental health clinic is greeted by a neighbor who says, "How is Michelle doing? She is my best friend and is seen at your clinic every week. Which is the most appropriate nursing response? a. "I know you are really concerned, so I will share with you that...
310 Chapter 17 How Law 29. The wrong medication was give in patient care. was given to the Describe the proce...
310 Chapter 17 How Law 29. The wrong medication was give in patient care. was given to the Describe the process of compliance reporting with CHAPTER REVIEW Circle the correct anstr. 1. Which state law videlal protection for those assisting an injured person during an emergency? a Uniform Anatomical Gift Act b. Good Samaritan Act c Patient Self-Determination Act d. GINA 5. Which means individually identifiable hea information stored or transmitted by co entities or business associates? a permission |...
When it comes to billing and collection issues, some of the main rules that physician billers and biller services must follow are (Ch 9) determination of patient third-party status, amount of copayment that needs to be collected from the patient, correct coding, coordination of benefits, preauthoritzation of services, referral, second opinion, fraud and abuse regulations O collection of deductible, timely coding, fraud and abuse regulations, provider credential verification, second option, income verification, coordination of benefits o preauthorization of services, access...
3. Match the financial classes in the first column to their definitions in the second column. Commercial insurance A. Countrywide health program for certain people and families with low income and resources. It is jointly funded by the Guarantor federal government and the individual states and is run by Medicaid each individual state. Workers compensation B. Includes all of the insurance companies who provide coverage Employee health to employers for when their employees are injured while working. Medicare C. Includes...
1. What are the three major payer categories? A. Personal health B. Employee health C. Family health D. Workers compensation E. National health F. Group health 2. Which of the following pays the highest rates for healthcare services? A. Commercial health insurance B. Medicaid C. Self pay patients D. Medicare E. Guarantors of patients 3. Match the financial classes in the first column to their definitions in the second column. _Commercial insurance A. Countrywide health program for certain people and...
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....
KEY TERMS to hog ho MATCHING Match the definition with the correct term from the following word list. A. administrative code set B. billing provider C. carrier block D. claim attachment E claim control number claim filing indicator code G. claim frequency code (claim submission eason code) H. claim soruhter I clean claims Q. HIPAA XI2 837 Healh Care Claim Professional (R37P) R. line item conl nember S. National Uniform Claim Committee (NUCC) T. other ID nunber U. ostside lahoratory...
46. Which situation(s) are classified as natural disasters? Select all that apply. a. Blizzards b. Terrorist attacks e. Volcanic eruptions d. Structural collapse e. Communicable diseases 47. The nurse employed in a mental health clinic is greeted by a neighbor who says, "How is Michelle doing? She is my best friend and is seen at your clinic every week. Which is the most appropriate nursing response? a. "I know you are really concerned, so I will share with you that...
310 Chapter 17 How Law 29. The wrong medication was give in patient care. was given to the Describe the process of compliance reporting with CHAPTER REVIEW Circle the correct anstr. 1. Which state law videlal protection for those assisting an injured person during an emergency? a Uniform Anatomical Gift Act b. Good Samaritan Act c Patient Self-Determination Act d. GINA 5. Which means individually identifiable hea information stored or transmitted by co entities or business associates? a permission |...
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