Out of pocket payment - Study guides, Class notes & Summaries

Jerome was shopping at ABC Imports when a light fixture fell from the ceiling and hit him on the head. Jerome's injuries resulted in an extended hospital stay, so he sued ABC Imports and was awarded $400,000. Assuming ABC Imports carries a CGL with a General Aggregate of $750,000 and a per occurrence limit of $250,000, what is the maximum that ABC's insurer will pay for Jerome's injuries? - CORRECT ANSWER $250,000 Strict Liability: - CORRECT ANSWER holds a person liable for h...

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...

Test Bank for Medical-Surgical Nursing 5E Holly Stromberg Chapter 01: Caring for Medical-Surgical Patients Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs b. To define the scope of LPN/LVN practice c. To improve the quality of care provided by the LPN/LVN d. To limit the LPN/LVN employment placement ANS: B While improv...

1. The major provisions of the Patient Protection & Affordable Care Act of 2010 were?Answer: -Banning of preexisting condition coverage limitations -Free preventative care -Medicaid expansion 2. Which of the following statement(s) about the finance department a t large healthcare organizations is/are correct?Answer: -The CFO typically reports directly to the chief executive officer (CEO) -The CFO is usually assisted by a comptroller and treasurer -The department is headed by the chief finan...

TEST BANK FOR MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 3TH EDITION DEWIT-1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defi...

TEST BANK : MEDICAL SURGICAL NURSING: CONCEPTS & PRACTICE 3RD EDITION BY deWit (CHAPTER 1-48)Chapter 01: Caring for Medical-Surgical Patients Chapter 02: Critical Thinking and the Nursing Process Chapter 03: Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy Chapter 04: Care of Preoperative and Intraoperative Surgical Patients Chapter 05: Care of Postoperative Patients Chapter 06: Infection Prevention and Control Chapter 07: Care of Patients with Pain Chapter 08: Care of Patients wi...

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 ...

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

Comprehensive Final Certification Exam: Illinois Health Insurance (Xcel Solutions) Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home? - Answer ️️ -home health care Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n) - Answer ️️ -deductible When a producer submits an insurance applicaton, the application is REQ...

Lender Interest Provisions - Answer Protects lender interest by allowing the lender certain rights in the policy. Coinsurance Penalty - Answer A property insurance provision that penalizes the insured's loss recovery if the limit of insurance purchased by the insured is not equal to or greater than a specified percentage (commonly 80 percent) of the value of the insured property. Underinsured - Answer A situation resulting from a failure to carry enough coverage on the value of a property...