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

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED 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 patie...

Reimbursement Methodologies Exam 3 Questions and Answers Already Passed What does "reimbursement methodology" refer to in healthcare? a. The process of hiring healthcare providers b. The system used to determine how healthcare providers are paid for services rendered c. The coding systems for diagnoses d. The administrative tasks involved in patient care How do managed care organizations typically influence reimbursement? a. By negotiating payment rates and controlling healthcare c...

Healthcare Reimbursement Chapters 8+ Latest Version Already Passed How do insurance plans typically categorize services for reimbursement? Insurance plans categorize services based on various criteria such as type of care, urgency, and medical necessity, influencing the coverage and reimbursement rates. What role does the Medicare Severity Diagnosis Related Groups (MS-DRGs) play in reimbursement? MS-DRGs classify hospital cases into groups that are expected to have similar hospi...

is a pre-determined amount that the patient pays before the insurer begins to pay for services - ANSWERdeductible a percentage of the insurance payment amount that is paid by the patient, along with the amount paid by the insurer. - ANSWERcoinsurance a flat amount that the patient pays at each time of service - ANSWERcopayment payment also includes amounts for services that are not included in the patient's benefit design and amounts for services balance billed by out-of-network provid...

Medicare Prescription Payment Plan - Beginning in 2025, the prescription drug law, known as the Inflation Reduction Act, requires all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage — to offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly payments instead of all at once at the pharmacy. Benefits of Medicare Pre...

MHA 702 Chapter 10-12 Questions and Answers Already Passed Question: What are the primary sources of revenue for most healthcare organizations? Answer: The primary sources of revenue include patient services, government reimbursements such as Medicare and Medicaid, private insurance payments, and out-of-pocket payments from patients. Question: How does value-based care differ from fee-for-service in healthcare reimbursement models? Answer: Value-based care focuses on rewarding ...

C425 WGU Objective assessment study guide questions and correct answers 2022VISN-veterans integrated service networks coordinates its own services and receives federal funds/ The hallmark of US healthcare industry Access is restricted to those who -Have health insurance through employer -are covered under a government program -can afford to buy insurance out of pocket -are abel to pay for services privately Holistic medicine treast the whole person/ incorporates alternative t...

Under a traditional IRA, interest is taxed: Only if withdrawn prior to age 59 1/2 According to the capital gains rate Upon distribution During the accumulation phase - ANSWER-Upon distribution Which of these statements concerning Traditional IRAs is CORRECT? Earnings are not taxable when withdrawn Earnings are taxable when withdrawn Contribution are never tax deductible Contributions are always made by the employer - ANSWER-Earnings are taxable when withdrawn Wh...

In a Life insurance contract, an insurance company's promise to pay stated benefits is called the: a) insuring clause b) consideration clause c) entire contract d) owner's rights - ANSWER insuring clause under which circumstance MUST a health insurer have an expedited grievance review procedure? - ANSWER when the enrollee's life or health is jeapordized The Consideration clause in a life insurance contract contains what pertinent information? - ANSWER amount of premium payments and...

AHIP – 2024 FINAL EXAM || Complete Questions & Answers (Rated A+) AHIP – 2024 FINAL EXAM || Complete Questions & Answers (Rated A+) Insurer vs Insured - ANSWER - - insurer is a company that provides plan - insured are the people that buy into the plan Group health insurance - ANSWER - Health coverage provided by employers to members of a group. Group health insurance - types of coverage - ANSWER - You can choose among several or just one depending on your employer * dental, visio...