Exam (elaborations)
HPEX 300 Practice Questions with Correct Answers
- Course
- Institution
HPEX 300 Practice Questions with Correct Answers
[Show more]
Content preview
HPEX 300 Practice Questions with Correct AnswersSelf-funded or self-insurance programs are health insurance programs
that are implemented and controlled by the company itself. They retain
all of the risk in providing health insurance to their employees by paying
any claims from their employees. Both the employee and employer pay
into the fund.
True/False Correct Answer-True
A company who provides their own health insurance will purchase
reinsurance from another insurance company to protect themselves from
any catastrophic losses. The reinsurance sets a stop-loss measure that
limits the amount the company will pay for claims.
True/False Correct Answer-True
Select the answer that best applies.
In a healthcare organization, which healthcare position is responsible for
accounting and reporting functions?
Treasurer
Internal auditor
Comptroller
Compensation officer Correct Answer-Comptroller
Flexible spending accounts (FSAs) provide employees with the option of
setting aside pretax income to pay for out of pocket medical expenses.
Employees must submit claims for these expenses and are reimbursed
,from their spending accounts. The amount set aside can be rolled over in
the next year.
True/False Correct Answer-False
The Flexible Spending Account (FSA) has the following characteristics:
-an option of setting aside pretax income to pay for out-of-pocket
medical expenses.
-the funds accumulated over a year must be spent within the year.
-allows employees who work for small companies (less than 50
employees) who have high deductible plans, to use an MSA to set aside
pretax dollars to be used for their premiums and nonreimbursed
healthcare expenses.
-All of these are correct. Correct Answer--All of these are correct.
Most insurance policies require a monetary contribution from the
covered individual which is called a:
copayment
deductible
coinsurance
All of these are correct. Correct Answer-All of these are correct.
What is Medicare Part B?
-It is the managed care component of Medicare.
-Provides for prescription drug plans.
-Supplemental health plan to cover physician services.
,-It is financed from payroll taxes. Correct Answer-Supplemental health
plan to cover physician services.
Why was health insurance developed?
-To reduce the amount of absenteeism by employees.
-Companies felt responsible for the health of their employees.
-Companies wanted to provide free healthcare services to their
employees.
-Like homeowner's insurance or life insurance, provide protection to an
employee in the event they required health care. Correct Answer-Like
homeowner's insurance or life insurance, provide protection to an
employee in the event they required health care.
Flexible spending accounts (FSAs) provide employees with the option of
setting aside pretax income to pay for out-of-pocket medical expenses.
Employees must submit claims for these expenses and are reimbursed
from their spending accounts. The drawback is that the amount set aside
must be spent within one year.
True/False Correct Answer-True
A company who provides their own health insurance will purchase
reinsurance from another insurance company to protect themselves from
any catastrophic losses. The reinsurance sets a stop-gap measure that
limits the amount the company will pay for claims.
True/False Correct Answer-False
, Preferred provider organizations (PPOs) are the oldest type of managed
care. Members must see their primary care provider first in order to see a
specialist.
True/False Correct Answer-False
Managed care refers to the cost management of healthcare services
utilization by controlling who the consumer sees and how much the
service costs.
True/False Correct Answer-True
Which of the following are cost-control measures of managed care
organizations?
-Restrictions on provider choices.
-Establishing a gate keeper or primary care provider as the coordinator
of their patient's services.
-A review of the different types of services being provided.
-All of these are correct. Correct Answer-All of these are correct.
Point-of-service plans are a type of HMO-PPO hybrid. They encourage
plan members to seek but are not required to use a primary care provider
who will become the gatekeeper of services. Members will receive lower
fees if they use a gatekeeper model.
True/False Correct Answer-True
Prospective utilization review is:
The benefits of buying summaries with Stuvia:
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
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
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 cracker. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79064 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now