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5 Written questions

5 Matching questions

  1. Which replaced the 1908 workers' compensation
    legislation & provided civilian employees of the federal government w/medical car, survivors' benefits, & compensation for lost wages?
  2. The primary intent of HIPPA legislation is to__
  3. HIPPA includes:
  4. Whick term best describes those who receive managed healthcare plan services?
  5. The percentage of costs a patient shares w/the health plan is called__?
  1. 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
  2. b Coinsurance
  3. c create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
  4. d enrollees
  5. e Federal Employees' Compensation Act

5 Multiple choice questions

  1. Franklin Health Assurance Company
  2. facilities were required to provide services free or at reduced rates to patients unable to pay for care
  3. -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
  4. ensure continuity of care
  5. involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments

5 True/False questions

  1. Third-party administrators (TPAs) administer healthcare plans & process claims, serving as a ___?replace fee-for-service plans with affordable, quality care to healthcare consumers


  2. The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS).Coinsurance


  3. Established quality standards for all laboratory testing to ensure the accuracy, reliability, & timelines of patient test results.Regardless of where the test was performed


  4. The intent of managed health care was to:create better access to health insurance, limit fraud & abuse, and reduce administrative costs.


  5. The term that describes requirements created by accreditation organizations is ___.enrollees


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