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FLAVIN MOS150U1
Theory TEST
| Question | Answer |
|---|---|
| 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 |
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Iteach4Docs
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