5 Written questions
5 Matching questions
- Which replaced the 1908 workers' compensation
legislation & provided civilian employees of the federal government w/medical car, survivors' benefits, & compensation for lost wages?
- The primary intent of HIPPA legislation is to__
- HIPPA includes:
- Whick term best describes those who receive managed healthcare plan services?
- The percentage of costs a patient shares w/the health plan is called__?
- a -improve the portability & continuity of health insurance coverage in the group & individual markets
-combat waste, fraud & abuse in health insurance & healthcare delivery
-improve access to long-term care services & coverage
- b Coinsurance
- c create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
- d enrollees
- e Federal Employees' Compensation Act
5 Multiple choice questions
- Franklin Health Assurance Company
- facilities were required to provide services free or at reduced rates to patients unable to pay for care
- -excessive charges for services, equipment, or supplies
-submitting claims for items or services that are not medically necessary to treat the patient's stated condition
-improper billing practices that result in a payment by a government program when that claim is the legal responsibility of another third-party payer
-voilations of participating provider agreements w/insurance companies
- ensure continuity of care
- involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments
5 True/False questions
Third-party administrators (TPAs) administer healthcare plans & process claims, serving as a ___? → replace fee-for-service plans with affordable, quality care to healthcare consumers
The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS). → Coinsurance
Established quality standards for all laboratory testing to ensure the accuracy, reliability, & timelines of patient test results. → Regardless of where the test was performed
The intent of managed health care was to: → create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
The term that describes requirements created by accreditation organizations is ___. → enrollees