Medicare advantage plans Study guides, Class notes & Summaries

AHIP Final Exam Test Questions 2020-2024 FINAL EXAM 250 Q/A TEST BANK America's Health Insurance Plans (AHIP) Exam Study Guide Questions & Answers 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? - ANSWER He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialy...

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - ANSWER Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney tr...

CSPR - Certified Specialist Payment Rep (HFMA) Exam (Latest 2024) Questions & Verified Answers 100% Guaranteed Grade A+ Example Question & Answer: Identify the various types of government‐sponsored health coverage: - Answer - Medicare - Government; Beneficiaries enrolled in such plans, but, participation in these plans is voluntary. Medicaid Medicaid Managed Care - Medicaid beneficiaries are required to select and enroll in a managed care plan. Medicare Managed Care (a.k.a. Medicare ...

Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but replace her existing Medigap plan with one that provides drug coverage. What should you tell her? correct answersMrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has bee...

CRCR Exam Prep What are collection agency fees based on? - correct answer A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - correct answer Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - correct answer Case rates What customer service improvements might improve the patient accounts department? - correct answer Ho...

AHIP - Final Examination (Latest Update 2022) Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his ...

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

The Payroll Source CPP Practice Exam 100 Questions with Verified Answers Which of the following is LEAST likely to be considered when looking at the security of a new payroll system? A. regular data back-up and storage B. protection against computer viruses C. limited system access D. system edits - CORRECT ANSWER D. system edits Company deadlines for payroll data input documents are essential for: A. timely processing of the payroll B. accurate entry of data C. guaranteeing that al...

UHC Medicare Basics Test A consumer currently has original Medicare and is enrolled in a stand alone prescription drug plan what will happen if the consumer enrolls in an MA plan that has integrated prescription drug coverage - ANSWER-the consumer will be automatically disenrolled from the standalone PDP upon in Roman in the MA plan that has integrated prescription drug coverage aside from a standalone Medicare prescription drug plan how else could a Medicare eligible consumer get Part ...

AHIP 2024 Exam 3 | A++ Exam with All New Qs & As - Guaranteed Pass! 1. Mr.Wells is trying to understand the difference between Original Medicareand Medicare Advantage. What would be the correct description? Answer: Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. 2. Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what type of plan designs are available through...