100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
Chapter 12: Health Insurance Essentials Test Bank Kinn’s The Clinical Medical Assistant, 14th Edition Niedzwiecki $17.99   Add to cart
Quickly navigate to
Preview
  2.  
  3. Chapter 12 Health Insurance Essentials
  4.  
  5. Chapter 12 Health Insurance Essentials

Exam (elaborations)

Chapter 12: Health Insurance Essentials Test Bank Kinn’s The Clinical Medical Assistant, 14th Edition Niedzwiecki

1 review
 186 views  0 purchase
  • Course
  • Chapter 12 Health Insurance Essentials
  • Institution
  • Chapter 12 Health Insurance Essentials

Chapter 12: Health Insurance Essentials Test Bank Kinn’s The Clinical Medical Assistant, 14th Edition Niedzwiecki

Preview 3 out of 16  pages

Document information

  • July 21, 2023
  • 16
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

Subjects

Connected book

book image

Book Title:

Author(s):

  • Edition:
  • ISBN:
  • Edition:

More summaries for

All for this textbook (52)

Written for

  • Chapter 12 Health Insurance Essentials
  • Chapter 12 Health Insurance Essentials

1  review

review-writer-avatar

By: rylyn_colesmom • 7 months ago

Seller

avatar-seller
UltimateStudyGuide

Reviews received

Content preview

Chapter 12: Health Insurance Essentials Niedzwiecki: Kinn’s The Clinical Medical Assistant, 14th Edition MULTIPLE CHOICE 1. The amount of money paid to keep an insurance policy in force is the: a. premium. b. deductible. c. copayment. d. co-insurance. ANS: A A premium is the periodic (monthly, quarterly, or annual) payment of a specific sum of money to an insurance company, for which the insurer in return agrees to provide certain benefits. REF: p. 244 OBJ: 1 TOP: Insurance: Terminolog y MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 2. Health insurance designed for military dependents and retired military personnel is called: a. CHAMPVA. b. TRICARE. c. Medicare. d. Medicaid. ANS: B TRICARE is the military’ s comprehensive healthcare program for family members of active duty personnel, military retirees and their eligible family members under age 65, and survivors of all uniformed services. REF: p. 247 OBJ: 2. List and discuss various government health insur ance plans. TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 3. Veterans of the U.S. armed forces may be covered by: a. CHAMPVA. b. TRICARE. c. workers’ compensation. d. Blue Cross/Blue Shield. ANS: A CHAMPVA, which is similar to TRICARE, is a health benefits program for the spouses and dependent children of veterans suffering total, permanent, service -connected disabilities and for surviving spouses and dependent children of veterans who died as a result of service -related disabilities. REF: p. 247 OBJ: 2. List and discuss various government health insurance plans. TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 4. Organizations that fund their own insurance programs offer their employees: a. group coverage. b. individual coverage. c. government plans. d. self-funded plans. ANS: D When companies or organizations have an employee base large enough to allow them to fund their own insurance program, it is called a self-funded plan . REF: p. 247 OBJ: 3 TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 5. The federal - and state -sponsored health insurance program for the medically indigent is called: a. Medicare. b. Medicaid. c. Medigap. d. MediCal. ANS: B Medicaid is a federal - and state -sponsored health insurance program for the medically indigent. REF: p. 246 OBJ: 2 TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 6. The amount of money the policyholder pays per claim before the insurance company will pay on the claim is known as the: a. exclusion. b. premium. c. deductible. d. remittance. ANS: C A deductible is a specific amount of money a patient must pay out of pocket before the insurance carrier begins paying. The deductible amount is met on a yearly or per -incident basis. REF: p. 244 OBJ: 1 TOP: Insur ance: Terminology MSC: CAAHEP: VIII.C.1.a | ABHES: 8.c 7. Which of the following is not an advantage of managed care? a. Healthcare costs are usually contained. b. Access to specialized care and referrals is limited. c. Most preventive medical treatment is covered. d. Out-of-pocket expenses tend to be less than traditional insurance. ANS: B Limitations on referrals and on access to specialized care are disadvantages of managed care. REF: p. 249 OBJ: 5 TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.2 | ABHES: 8.c 8. Which of the following is not a disadvantage of managed care? a. Authorized services usually are covered. b. Providers’ choices in the treatment of patients can be limited. c. More paperwork may be necessary. d. Reimbursement is historically less than with traditional health insurance. ANS: A Coverage of authorized services is an advantage of managed care. REF: p. 249 OBJ: 5 TOP: Insurance: Insurance Models/Managed Care MSC: CAAHEP: VIII.C.2 | ABHES: 8.c 9. Which part of Medicare covers prescription drug services? a. A b. B c. C d. D ANS: D Part D offers Medicare recipients the option of choosing, at a reduced cost, a p lan that pays for prescription drugs with just a small copayment from the patient. REF: p. 245 OBJ: 2. List and discuss various government health insurance plans. TOP: Insurance: Medicare/Medicaid MSC: CAAHEP: VIII.C.3.a | ABHES: 8.c 10. Which type of referral is usually processed immediately? a. Regular b. Urgent c. STAT d. All are correct ANS: C A STAT referral can be approved by telephone immediately after it is faxed to th e utilization review department. A STAT referral is used in an emergency situation as indicated by the provider. REF: p. 251 OBJ: 6 TOP: Insurance: Preauthorization/Referrals MSC: CAAHEP: VIII.C.2 | ABHES: 8.c 11. If Mr. Jones’ s insurance has a $500 deductible and then pays 80% of the charges, how much will his policy pay on his bill of $4,359? a. $3027.20 b. $3087.20 c. $3447.20 d. $3487.20 ANS: B $4359 – $500= $3859 $3,859  0.8 = $3,087.20. REF: p. 244 OBJ: 1 TOP: Insurance: Determine Benefit Information

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller UltimateStudyGuide. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $17.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling

Recently viewed by you

Exam (elaborations) ·

(0)

PGA Final questions and answers

$17.99
  • (1)
  Add to cart