What type of insurance is paid for by employers and takes advantage of purchasing power of
having large member numbers? - answer✔Group health plan
An internist sees a 20-year-old patient for an office visit. The patient needs to see an
endocrinologist for a consultation regarding her diabetes. The internist is a participating provider
in her plan. She can choose any provider she wishes for her consultation, but she will save
money if she sees a specialist that is in her network. She does not require a referral for her
consultation. What type of insurance does the patient have? - answer✔PPO
What are the options for a provider with regard to participation with Medicare? -
answer✔Providers may participate, may choose not to, or can op-out
A family practitioner sees a Medicare patient and bills a 99213. This provider has opted-out of
Medicare. His fee for the service is $125.00. Medicare's approved amount is $73.08, and the
patient has met $0 of his deductible. What can the provider bill the patient? - answer✔$125.00
Under the Patient Protection and Affordable Care Act, what was banned - answer✔Lifetime
Limits
What does ACA stand for? - answer✔Affordable Care Act
At what age are you eligible for Medicare Part A? - answer✔65
What is Medicare Part A? - answer✔Covers inpatient hospital care, as well as care provided in
skilled nursing facilites, hospice care, and home health care
What is Medicare Part b? - answer✔Covers medically necessary doctors' services, outpatient
care, DME, Mental health Services, ambulance services
What is Medicare Part C? - answer✔Medicare Advantage Plans - private plans
What is Medicare Part D? - answer✔Prescription drug coverage
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 Brightstars. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
