Hmo Study guides, Class notes & Summaries

Steps used to control costs of managed care include: - Answer Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - Answer Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - Answer HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a s...

ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) Which welfare program provides assistance to the needy? - ANSWER - Medicaid Barbara has the right to change the beneficiary designation on her life insurance policy. Barbara's beneficiary is a(n): - ANSWER - revocable beneficiary Within how many calendar days must all clean electronic health insurance claims be paid in Alabama? - ANSWER - 30 Which type of term policy a...

FLORIDA 2-15 INSURANCE LICENSE EXAM ACTUAL UPDATE WITH LATEST ONLINE WRITTEN EXAM QUESTIONS AND ANSWERS Accumulation units are converted into annuity units: A group life insurance plan in which the employer pays the entire premium is known as a ________________ plan. If a disabled worker covered under Social Security disability benefits recovers and then is disabled again within five years, a new waiting period is required before benefits begin again. Robert had an accident and qua...

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without chan...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

Kentucky Life and Health Insurance Exam (New 2024/ 2025 Update) Questions and Verified Answers| 100 % Correct| Grade A QUESTION The only party in an insurance contract that makes a legally enforceable promise is the insurance company. Because of this, insurance contracts are considered to be: conditional aleatory unilateral contracts of adhesion Answer: unilateral Insurance contracts are unilateral. This means that only one party (the insurer) makes any kind of ...

What type of insurance allows treatment virtually anywhere with a high deductible that policy holders are willing to pay? a. COBRA b. EPO c. PPO d. HMO - C Veterans with service related disabilities are eligible for case under which of the following programs: a. CHAMPUS b. Medicare c. CHAMPVA d. TRICARE - C _______________________ is usually sponsored and partially paid by an employer. a. TRICARE b. Private Insurance c. Group Health Insurance d. Worker's Aide - C _______________...

Test Bank for Psychology of Women and Gender, 1ebyMiriam Liss, Kate Richmond, Mindy Erchull Test Bank for Psychology of Women and Gender, 1ebyMiriam Liss, Kate Richmond, Mindy Erchull

Exam 1: NUR257/ NUR 257 (New 2023/ 2024 Update) Aging and Chronic Illness in Nursing Exam Review| 100% Correct- Galen QUESTION are eligibility? does medicare cover Answer: be eligible for social security t services & must be medically necessary QUESTION costs of medicare Answer: ed by employer & employee tax of 2.9% iciary in form of premiums, deductibles, co-pays QUESTION medicare part A Answer: care or short term rehab if receive social sec...