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5 Written questions

5 Matching questions

  1. HIPPA defines "abuse" as:
  2. Examples of "abuse" include:
  3. The Tax Equity & Fiscal Responsibility Act of 1982 enacted the ___ prospective payment system (PPS).
  4. The percentage of costs a patient shares w/the health plan is called__?
  5. Whick term best describes those who receive managed healthcare plan services?
  1. a Coinsurance
  2. b Diagnosis-related groups
  3. 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
  4. d involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments
  5. e enrollees

5 Multiple choice questions

  1. Baylor University in Dallas, Texas
  2. Franklin Health Assurance Company
  3. database, problem list, initial plan, progress notes
  4. facilities were required to provide services free or at reduced rates to patients unable to pay for care
  5. an intentional deception misrepresentation that someone makes, knowing it is false, that could result inan unauthorized payment

5 True/False questions

  1. 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


  2. Which is a primary purpose of the patient record?ensure continuity of care


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


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


  5. 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