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HOM EXAM 2 QUESTIONS WITH 100% CORRECT ANSWERS GRADED A+
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HOM EXAM 2 QUESTIONS WITH 100% CORRECT ANSWERS GRADED A+
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HOM EXAM 2 QUESTIONS WITH 100%CORRECT ANSWERS GRADED A+
Dependent Coverage is extended to age 29 under the Affordable Care Act
(ACA)
True or False Answer - false
The rate formula typically adjusts the base rate for all of the following factors
except:
Demographics
Geographical area
Eating habits
All of the above Answer - Eating habits
__ is the term for the rate at which medical services are used.
Consumption
Budgets
Utilization
,None of the Above Answer - Utilization
Applicants/groups with poor credit histories may be required to do which of
the following?
Produce a letter of credit
Produce some form of collateral
Pay premiums in advance of the coverage period
Any of the Above Answer - Produce a letter of credit
Produce some form of collateral
Pay premiums in advance of the coverage period
Which or effective forms of health care fraud control.
Establishing and monitoring ethics and compliance hotlines
Prepayment claims review and analysis
Coordination with local or national prevention groups and task force
All the above Answer - Establishing and monitoring ethics and compliance
hotlines
Prepayment claims review and analysis
Coordination with local or national prevention groups and task force
,Today's transactional processing systems auto adjudicate on average what
percentage of claims that are accepted into the processing system.
75%
70%
80%
85% Answer - 75%
_ involves calculating the premium to be charged for a specific individual or
group on the basis of information gathered during the ___ process.
Rating, Adjusting
Underwriting, Rating
Rating, Underwriting
None of the above Answer - Rating, Underwriting
What is the single most significant piece of social legislation since 1965?
The Patient Protection & Affordable Care Act of 2010
Omnibus Budget Reconciliation Act of 1989
, Deficit Reduction Act 1984
Omnibus Budget Reconciliation Act of 1989 Answer - The Patient Protection &
Affordable Care Act of 2010
What actions that a MCO can take to ensure the security and protection of
electronic health information.
&νβσπ;&νβσπ; Prevention
Audit
Monitor
All the above Answer - &νβσπ;&νβσπ; Prevention
Audit
Monitor
A managed care information system should be relied on for what core
operational competencies?
Benefit configuration & Employer group and member enrollment
&νβσπ;Claims payment & &νβσπ;Premium management
Provider enrollment, contracting and credentialing & &νβσπ;Customer services
All the above Answer - Benefit configuration & Employer group and member
enrollment
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