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5 Written questions

5 Matching questions

  1. The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS).
  2. Healthcare coverage offered by ___ is called group health insurance.
  3. The most common forms of "fraud" include:
  4. The Blue Shield concept grew out of the lumber & mining camps of the ___ region at the turn of the century?
  5. Third-party administrators (TPAs) administer healthcare plans & process claims, serving as a ___?
  1. a -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
  2. b Pacific Northwest
  3. c Diagnosis-related groups
  4. d employers
  5. e System of checks & balance for labor & management

5 Multiple choice questions

  1. catastrophic or prolonged
  2. enrollees
  3. Coinsurance
  4. medical foundation
  5. -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

5 True/False 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?
    Federal Employees' Compensation Act

          

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

          

  3. A __ is responsible for supervising & coordinating healthcare services for enrollees:replace fee-for-service plans with affordable, quality care to healthcare consumers

          

  4. The Hill-Burton Act provided federal grants for modernizing hospitals that had become obsolete because of a lack of capital investment during the Great Depression & WWII (1929 to 1945). IN return for federal funds.replace fee-for-service plans with affordable, quality care to healthcare consumers

          

  5. The first Blue Cross policy was introduced by?replace fee-for-service plans with affordable, quality care to healthcare consumers

          

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