5 Written questions
5 Matching questions
- HIPPA defines "abuse" as:
- Examples of "abuse" include:
- The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS).
- The percentage of costs a patient shares w/the health plan is called__?
- Whick term best describes those who receive managed healthcare plan services?
- a Coinsurance
- b Diagnosis-related groups
- c -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
- d involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments
- e enrollees
5 Multiple choice questions
- Baylor University in Dallas, Texas
- Franklin Health Assurance Company
- database, problem list, initial plan, progress notes
- facilities were required to provide services free or at reduced rates to patients unable to pay for care
- an intentional deception misrepresentation that someone makes, knowing it is false, that could result inan unauthorized payment
5 True/False questions
HIPPA includes: → -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
Which is a primary purpose of the patient record? → ensure continuity of care
The intent of managed health care was to: → create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
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 government health plan that provides healthcare services to Americans over the age of 65 is called ___? → replace fee-for-service plans with affordable, quality care to healthcare consumers