5 Written questions
5 Matching questions
- The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS).
- Healthcare coverage offered by ___ is called group health insurance.
- The most common forms of "fraud" include:
- The Blue Shield concept grew out of the lumber & mining camps of the ___ region at the turn of the century?
- Third-party administrators (TPAs) administer healthcare plans & process claims, serving as a ___?
- a -billing for services not furnished
-misrepresenting the diagnosis to justify payment
-soliciting, offering, or receiving a kickback
-falsifying certificates of medical necessity, plans of treatment, & medical records to justify payment
- b Pacific Northwest
- c Diagnosis-related groups
- d employers
- e System of checks & balance for labor & management
5 Multiple choice questions
- catastrophic or prolonged
- medical foundation
- -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
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
The term that describes requirements created by accreditation organizations is ___. → enrollees
A __ is responsible for supervising & coordinating healthcare services for enrollees: → replace fee-for-service plans with affordable, quality care to healthcare consumers
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
The first Blue Cross policy was introduced by? → replace fee-for-service plans with affordable, quality care to healthcare consumers