Or a ppo in - Study guides, Class notes & Summaries

AHIP 2025 Final Exam Questions and Answers (2024 / 2025) (Verified Answers).1. PPO, HMO, MSA, Cost Plan, PFFS ANS Types of Medicare Advantage Plans 2. Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles ANS Medicare-Medicaid plans 3. Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coin- surances and deuctibles. Different enr...

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...

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 ...

A nurse is explaining differences among various agencies that address healthcare. Nurse should note which of following are health care regulatory agencies? (Select all that apply.) A: American Nurses Association (ANA) B: Joint Commission C: State boards of nursing D: National League for Nursing (NLN) E: Food and Drug Administration (FDA) - B, . Joint Commission; C. State Boards of Nursing; E. Food and Drug Administration (FDA) Nurse is explaining various types of healthcare coverage clie...

Exam 1: NUR257/ NUR 257 (New 2023/ 2024 Update) Aging and Chronic Illness in Nursing Exam Review| 100% Correct- Galen QUESTION are eligibility? does medicare cover Answer: be eligible for social security t services & must be medically necessary QUESTION costs of medicare Answer: ed by employer & employee tax of 2.9% iciary in form of premiums, deductibles, co-pays QUESTION medicare part A Answer: care or short term rehab if receive social sec...

TEST BANK FOR RN ATI Fundamentals (All chapters 1- 58 with questions and answers)/Fundamentals of Nursing 10th Edition (10.0) Ati, Content Mastery Series Review Module 1. A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (Select all that apply.) A. Home health care B. Rehabilitation facilities C. Diagnostic centers D. Skilled nursing facilities E. Oncology centers 2. A nurse is explain...

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...

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...

Certain conditions, such as dismemberment or total and permanent blinds, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe? - presumptive disability Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss? - notice of claim Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following el...

ATI Fundamentals Remediation Exam 2024 A nurse is explaining differences among various agencies that address healthcare. Nurse should note which of following are health care regulatory agencies? (Select all that apply.) A: American Nurses Association (ANA) B: Joint Commission C: State boards of nursing D: National League for Nursing (NLN) E: Food and Drug Administration (FDA) -Answer-B, . Joint Commission; C. State Boards of Nursing; E. Food and Drug Administration (FDA) Nurse is expla...