AMERICAN HEALTH INSURANCE PLANS - AHIP EXAMS FULLY SOLVED GRADED A+

AHIP FRAUD WASTE & ABUSE Which of the following requires intent to obtain payment and the knowledge that the actions are wrong? - correct answer Fraud Which of the following is not potentially a penalty for violation of the law or regulation prohibiting fraud, waste and abuse (fwa)? - correct ...

2023 AHIP Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? - correct answer He may sign-up for Medicare at any time however coverage usually b...

AHIP 2023 MODULE 1 Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? - correct answer Original Medicare covers ambulance ...

AHIP MODULE 2 2023 Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? - correct answer She can enroll in the PPO, but she will not be able to purchas...

AHIP FINAL EXAM TEST QUESTIONS Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? - correct answer Medicare does not cover a...

AHIP FWA 2023 Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her? - correct answer Original Medicare covers ambulance servi...

AHIP FINAL EXAM QUESTIONS Types of Medicare Advantage Plans - correct answer PPO, HMO, MSA, Cost Plan, PFFS Medicare-Medicaid plans - correct answer Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles Medicare Cost Plan ...

AHIP MODULE 1 Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. What should you tell her? Ch...

AHIP 2023 MODULE 3 Mrs. Roswell is a new Medicare beneficiary who has just retired from retail work. She is interested in selecting a Medicare Part D prescription drug plan. She takes a number of medications and is concerned that she has not been able to identify a plan that covers all of her med...

AHIP 2023 MODULE 4 This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they have selected. What should you do? - correct answer You ma...

AHIP MODULE 3 Mr. Jacob understands that there is a standard Medicare Part D prescription drug benefit, but when he looks at information on various plans available in his area, he sees a wide range in what they charge for deductibles, premiums and cost sharing. How can you explain this to him? - ...

AHIP 2023 - CHAPTER 5 Mrs. Johnson calls to tell you she has not received her new plan ID card yet, but she needs to see a doctor. What can she expect to receive from the plan after the plan has received her enrollment form? - correct answer Evidence of plan membership, information on how to obta...

AHIP 2023 MEDICARE FRAUD, WASTE, & ABUSE WITH VERIFIED CORRECT ANSWERS False Claims Act (FCA) Federal law prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. Penalty up to three times Governments Damages PLUS a penalty. Healthc...

AHIP GENERAL COMPLIANCE- MEDICARE - FWA - FRUAD, WASTE AND ABUSE WITH COMPLETE SOLUTIONS Compliance is the responsibility of the compliance officer, compliance committee and upper management only - answer False Ways to report a compliance issue include - answer All of the above What is the ...