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5 Written questions

5 Matching questions

  1. The most common forms of "fraud" include:
  2. Healthcare coverage offered by ___ is called group health insurance.
  3. The difference between "fraud" & "abuse" is:
  4. The percentage of costs a patient shares w/the health plan is called__?
  5. Which is a primary purpose of the patient record?
  1. a Coinsurance
  2. b employers
  3. c -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
  4. d the individual's intent
  5. e ensure continuity of care

5 Multiple choice questions

  1. an intentional deception misrepresentation that someone makes, knowing it is false, that could result inan unauthorized payment
  2. involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments
  3. enrollees
  4. Diagnosis-related groups
  5. create better access to health insurance, limit fraud & abuse, and reduce administrative costs.

5 True/False questions

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

          

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

          

  3. Major medical insurance provides coverage for ___ illnesses & injuries, incorporating large deductibles & lifetime maximum amounts.employers

          

  4. The first Blue Cross policy was introduced by?Baylor University in Dallas, Texas

          

  5. Examples of "abuse" include:involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments

          

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