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Theory TEST

Many employed individuals obtain healthcare coverage through a/an group plan
A special tax shelter set up for the purpose of paying medical bills is a/an medical savings account
Actuaries use statistics to predict anticipated healthcare costs, which establish premiums
The two new types of healthcare plans mentioned in the text that are “on the horizon” are Health Insurance Exchanges and Accountable Care Organizations
The federal act that states that Medicare is the secondary payer in the case of automobile or liability coverage is the Federal Omnibus Budget Reconciliation Act of 1980
Health insurance narrows down undesirable events to illnesses and injuries
The act that made Medicare benefits secondary to employer group health plans for employees (or spouses) older than 65 is the Tax Equity and Fiscal Responsibility Act of 1982
When an individual is eligible for coverage under two different health insurance policies, ________ typically governs payment. coordination of benefits
A relatively new concept of healthcare structure that emerged in the late 20th century is managed care
An insurance contract made with a business entity that covers its employees equally is called a/an group contract
Upcoding and unbundling of charges are examples of healthcare fraud
Exceptions to confidentiality include all of the following except emergency treatment
When both basic and major medical coverage is combined into one insurance plan, it is called a comprehensive plan
A health insurance company is referred to as the _____ party. third
Most third-party payers do not pay for medical services that are not medically necessary
When an individual purchases a healthcare policy from a commercial insurer, he or she is said to have a/an individual contract
Members of a medical team who are not physicians are called _____ members. ancillary
An authorization to release information should contain all of the following except the primary diagnosis
A contract can be terminated when both parties agree to terminate it & either party defaults on the provisions
The traditional kind of health insurance wherein patients can choose any provider or hospital they wish and change physicians at will is indemnity & fee-for-service
In compliance with HIPAA, when patients visit their healthcare providers for treatment, they are given a/an privacy statement
Identify which of the following is not a valid way to prevent fraud and abuse in the medical office. discuss potential problems with law enforcement professionals
Elements of a legal contract include all of the following except an attorney
Insurance payments are typically based on UCR rates
The type of contract that exists between a healthcare provider and a patient is a/an _____ contract. implied
Created by: Iteach4Docs