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5 Written Questions

5 Matching Questions

  1. The intent of managed health care was to:
  2. The percentage of costs a patient shares w/the health plan is called__?
  3. The government health plan that provides healthcare services to Americans over the age of 65 is called ___?
  4. The difference between "fraud" & "abuse" is:
  5. The most common forms of "fraud" include:
  1. a Medicare
  2. b Coinsurance
  3. c -billing for services not furnished
    -misrepresenting the diagnosis to justify payment
    -soliciting, offering, or receiving a kickback
    -unbunding codes
    -falsifying certificates of medical necessity, plans of treatment, & medical records to justify payment
  4. d replace fee-for-service plans with affordable, quality care to healthcare consumers
  5. e the individual's intent

5 Multiple Choice Questions

  1. database, problem list, initial plan, progress notes
  2. enrollees
  3. facilities were required to provide services free or at reduced rates to patients unable to pay for care
  4. ensure continuity of care
  5. primary care provider

5 True/False Questions

  1. The Blue Shield concept grew out of the lumber & mining camps of the ___ region at the turn of the century?Pacific Northwest

          

  2. Which was the first commercial insurance company in the US to provide private healthcare coverage for injuries not resulting in death?Franklin Health Assurance Company

          

  3. HIPPA includes:involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments

          

  4. The primary intent of HIPPA legislation is to__create better access to health insurance, limit fraud & abuse, and reduce administrative costs.

          

  5. Which replaced the 1908 workers' compensation
    legislation & provided civilian employees of the federal government w/medical car, survivors' benefits, & compensation for lost wages?
    create better access to health insurance, limit fraud & abuse, and reduce administrative costs.

          

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