Prepaid service plans - Study guides, Class notes & Summaries

Alan is an enrollee of a health maintenance organization (HMO) which uses a gatekeeper system. If there ever comes a time when he needs emergency health services, what should he do? Receive permission from the primary physician to begin treatment. Call the HMO to verify coverage. Proceed to the nearest emergency room. Contact the HMO for a listing of approved providers. - Proceed to the nearest emergency room. What is a major difference between private commercial insurers and HMO's? ...

From what taxes are cafeteria plan contributions generally exempt? A. SS, Medi, FIT, and FUTA B. FIT and SIT C. SS, Medi, FUTA, and SUI D. SS, Medi, FIT, and SIT - A. Social Security, Medicare, FIT, and FUTA Reference 4.5 Cafeteria Plans In which boxes on the W-2 would you report the adoption assistance? A. Boxes 3, 4, 5, 6 B. Boxes 1, 2, 3, 4, 5, 6, 12 - Code T C. Boxes 3, 4, 5, 6, 12 - Code A D. Boxes 3, 4, 5, 6, 12- Code T - D. Boxes 3, 4, 5, 6, 12- Code T Reference 3.3 - 7 Adoptio...

H has suffered a covered disability away from her job and will shortly begin collecting benefits. The insurer sends a letter to H stating that she will not receive any benefit amounts greater than her income. This clause is known as: A: Over-insurance clause B: free look C: relation of earning to insurance D: relation of economic value - answer-C: relation of earning to insurance The insured should be aware of the issue date upon delivery a policy and the date should be listed on: A: the...

TN Health Insurance Latest Update Already Passed Conditional Receipt If initial premium is paid at time of application, the producer with issue a continual receipt. Provides that coverage will become effective as of either the date of application or the date of completion of any required medical exam - which ever is later. Underwriting The process of selection, classification, and rating, The process of determining if someone is insurable, classifying risk, and determining rate or premium. Sou...

HCA 395 Exam #1 Study Guide Quizzes With All Correct Answers GRADED A+ CHAPTER 1 - ANS What is Workers' Compensation? - ANS In the early 1900s a program called Workers' Compensation was created. Benefits were made available to most employees to help cover healthcare costs that are due to a work-related injury. The Great Depression: Hospital Service Plans and Prepaid Group Service Plans (what were they, who started them, which health services were covered by each, what did they evolve...

Pays health care provider for service and then submits a claim to the insurer for reimbursement Free Look Provision fee-for-service deductibles indemnity policy 1 of 116 Definition Share cost with a managed care provider Medicare Supplement Insurance Self-insurers commercial insurance companies managed care plans 2 of 116 Definition 90 days Notice of claims Claim forms Misstatement of age Proof of loss 3 of 116 EXAM Definition A stated sun of money that the insured must pay...

The insured and insurance company will share the cost of covered losses under which health policy feature? - Answer Payment of Claims provision M applies for a health insurance policy and pays the initial premium. When the agent completes the application, a conditional receipt is left with the applicant. The insurance company's underwriting department request's M's medical records and determines that M has had asthma for many years. All of the following are probable underwriting outcome...

Life, Accident and Health Insurance Exam 2024 Questions Complete Solutions Qualified Plan - Answer - -approved by IRS for favorable tax treatment - tax deffered growth Qualified Plan Requirements - Answer - 1) Be in writing 2)provided for benefit of employee 3) must satisfy age and serive standards 4) cannot be discriminatory 5) contributions cannot exceed yearly maximus 6) must provide survivorship benefits 7) must meet miniumum vesting standards 8) cannot be top heavy Advantages of Q...

Certified Revenue Cycle Representative (CRCR) Exam Bank Complete Questions and Answers 100% Verified| Latest 2024 CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR (2024) What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the p...

Chapter 10: Healthcare Organizations (Leading and Managing in Nursing) Exam 2024 To prepare for the orientation of newly hired nurses, the nurse manager plans a presentation outlining the concept of healthcare networks. Healthcare networks are: a. units that provide only primary care services. b. owned by the institutions. c. a feature of all public institutions. `d. units that serve large populations. -Answer-ANS: D Healthcare networks are interconnected units. Their aim is serving lar...