Medicare cost plans - Study guides, Class notes & Summaries

Multi-Line Insurers - CORRECT ANSWER-________-______ Insurers are insurance carriers that offer more than one line of insurance. False - CORRECT ANSWER-True or False? Stock Insurance Companies are "participating" in that the policyholders receive dividends. Attorney-In-Fact - CORRECT ANSWER-Reciprocal Insurers are managed by an ___________________. Association - CORRECT ANSWER-Contrary to popular opinion, Lloyd's of London is not an insurer but rather an ____________. Limits Catas...

Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest Rated A+. Which government insurance plans offers 4 different parts or areas of different coverage? A. MedicareB. Medicaid C. TRICARE D. CHAMPVA 2. DAW/DNS stand for which of the following? A. Dispense as written B. Distribute and work C. Distribution and working D. Dispense as well 3. Which of the following third party plans requires the patient to designate a primary care physician (PCP)? A. Health ...

When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce enrollment in a plan? You may provide gifts or prizes to all potential enrollees during an event that does not exceed $15 in retail value. By contacting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefits package. What should you do to make sure yo...

PTCB Pharmacy Billing and Reimbursement Practice Test Questions and Answers Latest Rated 100%. DAW/DNS stand for which of the following? A. Dispense as written B. Distribute and work C. Distribution and working D. Dispense as well 3. Which of the following third party plans requires the patient to designate a primary care physician (PCP)? A. Health maintenance organization (HMO) B. Preferred provider organization (PPO) C. Medicare Part D D. TRICARE 4. The cost of the coverage of an i...

the drive for regulating health stems from controlling: correct answers quality, access, cost; they always have a trade off what was the first form of health insurance? correct answers Baylor Hospitals developed a plan for unlimited access by school teachers in return for prepayment in the form of a set monthly sum blue cross insurance correct answers first nonprofit insurance company that covered inpatient expenses; formed in 1939 the impact of WWII on health insurance? correct answers...

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? - Medicare is a program for people 65 or older and those under the age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. Mr. Schmidt would like to pla...

Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to use only network providers? A) PDP plan B) HMO plan C) PPO plan D) ESRD plan - B) HMO Which plan type allows members to see preferred doctors in network, doctors out of network and does not require referrals to a specialist? A) PDP plan B) Cost plan C) PPO plan D) HMO plan - C) PPO Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are called M...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

AHIP - Final Examination (Latest Update 2022) Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his ...

CRCR Exam Prep What are collection agency fees based on? - correct answer A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - correct answer Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - correct answer Case rates What customer service improvements might improve the patient accounts department? - correct answer Ho...