Prepaid service plans - Study guides, Class notes & Summaries

Medical Expense Insurance Exam Questions and Answers Which of the following characteristics does not apply to prepaid dental plans? - ANSWER Medical providers are paid on a capitation basis. The correct answer is: Medical providers are paid on a fee-for-service basis. Which of the following is typically not covered by a dental plan? - ANSWER Replacement of dentures is typically not covered by dental plans. The correct answer is: Replacement of dentures Which of the following are routin...

Information about Health Maintenance Organizations (HMOs) - ️️-Employers with more than 25 employees must offer an HMO as an alternative to their regular health plans. -Reduce cost of healthcare through preventative care -Needs to be approved by MN DHS -Provides services rather than reimbursement -Limited service area and providers -Prepaid basis, physicians paid per head of member (capation) -INPATIENT HOSPITAL CARE IN OR OUT NETWORK Preferred Provider Organization (PPO) - ️️-...

Health Insurance Exam| Questions and Verified Answers|100% Correct (2023/2024) Q: The provision in a group health policy that allows the insurer to post phone coverage for a covert illness 30 days after the policies a better day is referred to as the Answer: Waiting Period Q: The difference between group insurance and blanket health policies is Answer: Blanket health policies do not issue certificates Q: G is an accountant who has 10 employees and is concerned about ...

Identify elements of a well-functioning health care delivery system - Answer-Safe Effective Patient Centered Timely Equitable Describe strategies to increase access to affordable, high-quality care. - Answer-Establish a national focus Identifying and learning from errors Raising performance standards and expectations Implementing safety systems in health care organizations pay for performance penalties for excess readmissions Compare and contrast these health care delivery systems: ...

CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR (2021) questions and answers well illustrated. 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 ...

If you go outside of your network the member is responsible for ______% of the payment - 100 __________________ plan are normally selected by individuals who do not have access to a group plan or are a small business with many employees - Fee-for-service __________ corporations are charitable, educational, civic or humanitarian organizations whose profits are returned to the program of the corporation rather than distributed to shareholders and officers of the corporation - non-profit Blue...

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...

RMIN 4000 UGA Brown Test 4 Latest Update Already Passed fee-for-serive a separate fee is paid for each service copayment flat amount the insured must pay each time health services are received calendar year deductible an aggregate deductible that has to be satisfied only once during the calendar year coinsurance the percentage of the medical expenses the policyholder must pay in addition to the deductible amount Out-of-pocket maximum (stop-loss limit) the most the insured wil...

_________ is an Ownership benefit that helps customers track the status of the repair, see details of their work order, and interact with their service advisor in real time. - Service status customers can contact stellantis Roadside assistance via their mobile app or ________? - The roadside assistance number Factory- trained technicians performs standard Express Lane services on vehicles, such as oil change and filter, tire rotation, fluid top off, and_______ - complimentary multi-point in...

BCBS HAS A MANDATORY SECOND SURGICAL OPINION(SSO) REQUIREMENT NECESSARY WHEN A PATIENT IS CONSIDERING ELECTIVE, NON EMERGENCY SURGICAL CARE. THEINITIAL SURGICAL RECOMMENDATION MUST BE MADE BY A PHYSICIAN QUALIFIED TO PERFORMTHE ANTICIPATED SURGERY. IF A SECOND SURGICAL OPINION IS NOT OBTAINED PRIOR TO SURGERY, THE PATIENT'S OUT OF POCKET EXPENSES MAY BE ________. - INCREASED BLUE CROSS BLUE SHEILD PLANS ORIGINALLY COVERED ONLY HOSPITAL BILLS AND BLUE SHEILD PLANS COVERED FEES FOR PHYSICIA...