What is a ppo plan - Study guides, Class notes & Summaries

2024 Anthem Administrative Guidelines Exam I completed all my training on Friday. When will I know I'm ready to sell? - ANS Only after receipt of the confirmation email should arrive on Monday. Training completed one day should be validated the following business day. What tool does BlueCross provide for you to submit notes taken during the meeting with a prospect? - ANS Cavulus If a member chooses to cancel or withdraw an enrollment application or terminate enrollment in a plan ...

2023 Medicare Basics Test Questions with Correct Answers In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving social security benefits, unless they choose to delay their coverage? - Correct Answer Parts A and B Which statement is true about a member of a Medicare Advantage Plan who wants to enroll in a Medicare Supplement Insurance Plan? - Correct Answer When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automati...

AHIP FINAL EXAM QUESTIONS AND DETAILED ANSWERS MARCH 2024 LATEST GRADED A+. Mr. 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 Ans - He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for seve...

AHIP 2023/2024 FINAL EXAM REAL Q&A EXPERT VERIFIED GUARANTEED PASS LATEST UPDATE. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. What should you tell her? Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network. Romero is 64, retiring soon, and considering enrollment in his emplo...

Chapter 01: Caring for Medical-Surgical Patients deWit: Medical-Surgical Nursing: Concepts & Practice, 4th Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result...

ethics branch of philosophy applied ethics practical applications of moral standard laws binding rules determined by authority medical ethics moral conduct to regulate behavior of medical professionals beneficence principles of doing good veil of ignorance justice-based three-step ethics model Kenneth Blanchard and Norman Vincent Peale's approach to ethics R/O rule out a diagnosis gut feeling decision based on emotion A problem that occurs when using a duty-bas...

AHIP Practice Exam Questions and Answers 100% Correct Mr.Gomez notes that a Private Fee for Service (PFFS) plan avaliable in his area has an attractive preminum. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. What should you tell him? - Correct Answer ️️ - He may receive health care services from any doctor allowed to bill Medicare as long as he shows the doctor the plan's identification card and the doctor agrees to accept the PFFS pl...

1. Which of the following would not be accomplished with the purchase of an insurance policy? ANS Risk is eliminated 2. Individuals become eligible for Medicare Part A benefits at what age? ANS 65 3. At what point does a self-insured group qualify for a stop-loss coverage? ANS - When claims exceed a specified limit in a set period of time 4. What percentage of eligible employees must participate in a noncontributo- ry group health plan before it can be put in effect? ANS 100% 5. In a li...

AHIP FINAL EXAM QUESTIONS AND DETAILED ANSWERS MARCH 2024 LATEST GRADED A+. Mr. 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 Ans - He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for seve...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...