Bcbs and commercial - Study guides, Class notes & Summaries

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...

BCBS Study guide Questions with Correct Answers What covers the medical expenses of individuals and groups - Answer-Commercial insurance What covers car related financial losses - Answer-Automobile insurance Who covers Reimbursement for income lost as a result of a temporary or permanent illness or injury - Answer-Disability insurance SSDI and SSI provides - Answer-Assistance to people with disabilities For disability what is a base period - Answer-Wages earned in a 12 month period pri...

Third Party administrator that processes claims and helps run healthcare plan TPA You must make a ________ if an insurance company denies payment Appeal Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen The term for correct coding NCCI What plans are the largest commercial private health insurance plans? Blue Cross Blue Sheild A flat-fixed fee due a the time of service Co-pay What...

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...

BCBS Study guide Questions with Correct Answers What covers the medical expenses of individuals and groups - Answer-Commercial insurance What covers car related financial losses - Answer-Automobile insurance Who covers Reimbursement for income lost as a result of a temporary or permanent illness or injury - Answer-Disability insurance SSDI and SSI provides - Answer-Assistance to people with disabilities For disability what is a base period - Answer-Wages earned in a 12 month period pri...

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...

BCBS Study guide Questions with Correct Answers What covers the medical expenses of individuals and groups - Answer-Commercial insurance What covers car related financial losses - Answer-Automobile insurance Who covers Reimbursement for income lost as a result of a temporary or permanent illness or injury - Answer-Disability insurance SSDI and SSI provides - Answer-Assistance to people with disabilities For disability what is a base period - Answer-Wages earned in a 12 month period pri...

BCBS correct answer: Has insurance cards with 1-5 (usually 3) alpha characters preceding the ID number which need to be included when loading/verifying the insurance. Out of state BCBS plan correct answer: Don't automatically use BCBS out of state option; if claims billing address states to file thru local office, then use BCBS of TX option Tricare correct answer: Insurance for active duty military and their dependents and retired military and their dependents; administrated by Humana ...

BCBS Study guide Questions with Correct Answers What covers the medical expenses of individuals and groups - Answer-Commercial insurance What covers car related financial losses - Answer-Automobile insurance Who covers Reimbursement for income lost as a result of a temporary or permanent illness or injury - Answer-Disability insurance SSDI and SSI provides - Answer-Assistance to people with disabilities For disability what is a base period - Answer-Wages earned in a 12 month perio...

What is the definition of an Electronic Health Record (EHR)? 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)? An EMR is a digital version of a paper chart that contains all of a patient's medical history from one practice. List the types of insurance co...