Bcbs and commercial exam - Study guides, Class notes & Summaries

215 Insurance License Exam Questions And Answers risk pooling - ANS spreading risk over a large group of people law of large numbers - ANS larger the group, the more certain the predictions speculative risk - ANS not insurable - involves both chance of loss or gain pure risk - ANS insurable - involves chance of loss, never gain or profit peril - ANS event causing loss Ex: fire, death, accident, windstorm, disease hazard - ANS any factor that gives rise to p...

Basics Exam: EMR and EHR |Question and Answer| 100% Correct What is the definition of an Electronic Health Record (EHR)? *Ans* An EHR contains patient information from all providers involved in a patient's care. EHR data can be created, managed, and shared by authorized providers and staff from across more than one health care organization. What is the definition of an Electronic Medical Record (EMR)? *Ans* An EMR is a digital version of a paper chart that contains all of a patient...

HCM 425 Final Exam - Questions and Answers Programs of All-inclusive Care for the Elderly (PACE) work to limit out-of-pocket costs to beneficiaries by not applying deductibles, copayments, or other cost-sharing. Which is subject to Medicaid preauthorization guidelines? any extension of inpatient acute care hospital days Which services are exempt from Medicaid copayments? family planning services An individual whose income is a t or below 100 percent of the federal poverty level (FPL) and has r...

MHA 706 FINANCIAL MANAGEMENT FINAL EXAM AND STUDY GUIDE NEWEST VERSION 2024 /2025 ACTUAL EXAM 100 QUESTIONS AND CORRECT ANSWERS (100%) |ALREADY GRADED A+ Moral Hazard - -the risk of overuse of health services because the insured does not bear the full cost of the consequences copayments - -the fixed amount for a covered service that the insurer mandates that the patient pay to the provider before the patient receives services from the provider Medicare Part A - -covers...

Mock CPB Exam Practice Questions and Answers Court decisions that establish a standard use legal decisions to serve as authoritative rules or patterns in future similar cases. The legal term for standard is ______. a. decision b. example c. precedent d. statute - ANSWER-precedent Which is established in advance and based on reported health care charges from which a predetermined per diem rate is determined? a. prospective cost-based rate b. retrospective reasonable cost system c. pro...

AAPC CPB - CHAPTER 2: QUESTIONS WITH ANSWERS 2023 Why must a provider obtain an NPI number? I. To submit claims II. To prove that he is licensed III. To be HIPAA compliant IV. To guarantee payment by a health plan a. I, II, III b. II, III, IV c. I, II, III, IV d. I, III d. I, III A patient has receipts for her dental cleaning, vision exam, and contact lenses. Her employer has set up special accounts for each employee, there is no limit to the amount the employer can contribute...

AAPC CPC Chapter 1 correctly answered 2023MS-DRG Medicare Severity Diagnosis Related Group- Determines the amount the hospital will be reimbursed. EHR Electronic Health Record APC Ambulatory Payment Classification Outpatient coding * Provider Services, use CPT, HCPC level II and ICD10-CM Codes. * Work in provider offices, outpatient clinics, facility out patient department. *Also use APC's *More interaction with physician Inpatient hospital coding *Use ...

Mock CPB Exam Question and answers, 100% Accurate. Verified. Court decisions that establish a standard use legal decisions to serve as authoritative rules or patterns in future similar cases. The legal term for standard is ______. a. decision b. example c. precedent d. statute - -precedent Which is established in advance and based on reported health care charges from which a predetermined per diem rate is determined? a. prospective cost-based rate b. retrospective reasonable c...

An aging population will use more healthcare services to manage a multitude of chronic diseases. - ANS Which of the following is a reason for why the field of medical billing and coding is in high demand? Medical coding - ANS What is the process of reporting diagnoses and procedures/services as numeric and alphanumeric characters on the insurance claim? Telehealth - ANS What is the two-way, real time video visit between the patient and the physician at a distant site? Deduct...

HMGT 3311 Exam Review Ch 1,13,3,&2. All Questions with accurate answers. Rated A+ What did the Patient Protection and the Affordable Care Act (ACA) do for industry developments? - --Established the "Triple aim" - Political hot-topic, under constant challenge What do the Centers for Medicare and Medicaid Services (CMS) aiming to? - --Get the right care for the right patient, every time - Control costs by moving from a "quantity of care" (" prospective") reimbursement system to a ...