Covered expenses - Study guides, Class notes & Summaries

the transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses? correct answer: Subrogation the purpose of managed care health insurance is to correct answer: control health insurance claims expenses a man works for company A and his wife works for company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim correct answer: the ins...

National Coverage Determination (NCD) - Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Adjudication - Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form - A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Admitting clerk - A patient comes to the hospital for an inpatient procedure. Which of the following hospi...

Kentucky Health Insurance Exam | Study Questions and Verified Answers| 100 % Correct| Grade A (New 2024/ 2025 Update) QUESTION Individuals who itemize deductions can claim deductions for medical expenses not covered by health insurance that exceed what percent of their adjusted gross income? A. 5% B. 7% C. 10% D. 15% Answer: C. 10% QUESTION What is another name for an Administrative Services only arrangement? A. Self funding B. Third party administrator C. A modifie...

Personal Lines Insurance Practice Exam Questions and Answers Latest | 100% Correct. Bobby, age 16, borrows his parents' car without their permission and gets into an accident. Which of the following statements about coverage under the parents' personal auto policy is CORRECT? A) Bobby is covered by his parents' policy because he is included in the definition of named insured. B) Bobby is not covered for this accident because he used the car without permission. C) Bobby is not covered ...

Under which situation must insurable interest exist between the applicant and insured at the time of application? - When a third-party applicant names themselves beneficiary. Which of the following is true about a decreasing term life policy? - The face amount reaches zero at policy expiration. Which of the following occurs immediately after the application is submitted and the initial premium paid? - The underwriting process begins For an individual long-term care policy there is an annua...

Which policy provision permits the policy owner to take a specified number of days to examine the contract, and allows for cancellation and a full refund if the policy owner rejects the terms or costs? - Free Look When will a policy pay on a UCR basis? - When particular benefits are not listed on a payment schedule Which type of rider reimburses health and social service expenses incurred in a convalescent or nursing home facility? - long term care rider Which of the following is exempt...

This document contains workings, explanations and solutions to the TAX3701 Assignment 2 (QUALITY ANSWERS) Semester 1 2024. For assistance call or us on 0.6.8..8.1.2..0.9.3.4...... QUESTION 1 (40 marks, 72 minutes) Crystal (Pty) Ltd (“Crystal”) is a South African resident company with a 31 March financial year end. The company is a leading manufacturer and distributor of float glass, laminated glass, and various mirror products to customers in and outside South Africa. Crystal is registered ...

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...

TX ADJUSTER TESTSubrogate Subrogation is the right for an insurer to legally pursue a third party that caused an insurance loss to the insured. This is done as a means of recovering the amount of the claim paid by the insurance carrier to the insured for the loss. - correct answer While investigating a claim, you determine that the loss was caused by a defective mechanism in the dishwasher. You would attempt to_________________________? Appraisal - correct answer What is the process when an i...

Distinguish between Covered Property and Property Not Covered under the Businessowners Coverage Form. correct answers Covered: Buildings: Includes PP of landlord (common areas, furnished) Covers Bridges, Retaining Walls, Wharves, Docks Replacement Cost BPP: Includes Property of Others (in CCC) Exterior Building Glass Replacement Cost Not Covered: Money/Securities Fences, radios, antennas, towers, signs (detached) plants Installed computers (in vehicles etc) Electroni...