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5 Written questions

5 Matching questions

  1. 1984 Standardization of information submitted on Medicare claims:
  2. COBRA in 1985:
  3. Subscriber:
  4. Preauthorization:
  5. Health Maintenance Organization (HMO):
  1. a grants prior approval for reimbursement of a healthcare service
  2. b person in whose name the insurance policy is issued
  3. c The Consolidated Omnibus Budget Reconciliation Act allows employees to continue healthcare coverage beyond the benefit termination date.
  4. d HCFA (now called CMS) required providers to use the HCFA-1500 (now called the CMS-1500) to submit Medicare claims
  5. e provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis

5 Multiple choice questions

  1. 1939
  2. review for medical necessity of inpatient care prior to admission
  3. prospective payment system that reimburses hospitals for impatient stays
  4. provides benefits to subscribers who are required to receive services from network providers
  5. amount for which the patient is financially responsible before insurance policy provides coverage

5 True/False questions

  1. Discharge planning:arranging appropriate healthcare services for discharged patients.

          

  2. Preferred provider Organization (PPO):provides benefits to subscribers who are required to receive services from network providers

          

  3. What year First Blue Cross policy started:1939

          

  4. Integrated Delivery System (IDS):organization of affiliated providers' sites that offer joint healthcare services to subscribers

          

  5. HIPPA is to:provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.

          

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