An hmo - Study guides, Class notes & Summaries

What is an eligible building for flood insurance?: A structure with 2 or more outside rigid walls and a fully secure roof, built on a permanent site, with 50% or more of the value above ground level and located within an eligible community What is Builders Risk Coverage?: Covers buildings in the course of completion. Proper coverage is 100% of expected completed value Do all Homeowners policies contain Coverage A?: No, HO-4 (Renters person- al property) What is casual labor in workers' compen...

Maryland life and health insurance exam questions and answers already passed Which of the following regulates the quality of care provided by a health maintenance organization (HMO)? Secretary of the department of health and mental hygiene. A marketing system, which utilizes mass media advertising and mail, instead of a producer, is called an blank, blank marketing system. Direct response An insurer is life insurance premium rate must be the same for all individuals In the same risk class wit...

Kentucky Life and Health Insurance Exam (New 2024/ 2025 Update) Questions and Verified Answers| 100 % Correct| Grade A QUESTION The only party in an insurance contract that makes a legally enforceable promise is the insurance company. Because of this, insurance contracts are considered to be: conditional aleatory unilateral contracts of adhesion Answer: unilateral Insurance contracts are unilateral. This means that only one party (the insurer) makes any kind of ...

FLORIDA 2-15 INSURANCE LICENSE EXAM ACTUAL UPDATE WITH LATEST ONLINE WRITTEN EXAM QUESTIONS AND ANSWERS NEW UPDATE Accumulation units are converted into annuity units: A group life insurance plan in which the employer pays the entire premium is known as a ________________ plan. If a disabled worker covered under Social Security disability benefits recovers and then is disabled again within five years, a new waiting period is required before benefits begin again. Robert had an accid...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify 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 HMO Conventional PPO and POS H...

Xcel 2-15 Florida Life & Health State Exam Simulator Already Passed what is considered to be a characteristic of an immediate annuity benefit payments start within one payment period of purchase 3 MULTIPLE CHOICE OPTIONS which of these characteristics is consistent with a straight life policy premiums are payable for as long as there is insurance coverage in force 3 MULTIPLE CHOICE OPTIONS an insureds inability to perform two or more activities of daily living may trigger which type of life...

ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) Which welfare program provides assistance to the needy? - ANSWER - Medicaid Barbara has the right to change the beneficiary designation on her life insurance policy. Barbara's beneficiary is a(n): - ANSWER - revocable beneficiary Within how many calendar days must all clean electronic health insurance claims be paid in Alabama? - ANSWER - 30 Which type of term policy ...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-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 - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without chan...

Nevada Life and Health License Exam Prep Questions with 100% Correct Answers What are the four required elements of an insurance contract? - Answer- Agreement, consideration, competent parties, and legal purpose. What two parts make up a life insurance application? - Answer- General Information and the Medical Information. An agent's report can go in a life insurance application but is not included in the life insurance policy. When must insurable interest exist in life insurance? - Answ...