Single payer - Study guides, Class notes & Summaries

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...

MHA 710/ MHA710 Exam 3: (Latest 2024/ 2025) Questions and Verified Answers| Grade A| 100% Correct when the Q: Suppose the market for nursing services in a local community is so dominated by a single community hospital that, for all practical purposes, it is considered a monopsony. Using the diagram below, answer the question. What is the equilibrium wage and level of employment under monopsony? a. W0 and E1 b. W2 and E0 c. W0 and E0 d. W0 and E2 e. W1 and E1 Answer: c. W0 an...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-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 - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

MHA 610 Final Exam Questions & Answers 2023/2024 "What is meant by the term "health care costs" Give the 3 meanings - ANSWER-1. Billings and premiums that the patient pays 2.How much debt the nation is in for medical expenses 3. The cost of producing services such as supplies and equipment Rand Health - How does it show relationship of rising costs and third party reimbursement? - ANSWER-The experiment showed how people who paid out of pocket were less likely to utilize the services...

to add a new insurance to the system that dose not exist select a generic coverage and enter information from the card when creating a new coverage record in the system you must choose the correct ( 2 answers) payer and plan true or false a patient can have more then one guarantor account TRUE Guarantor account who will be paying coverage insurance (payer, plan) subscriber policy holder generic coverage the payer is not built into the system and must be a...

Healthcare Reimbursement -Study guide Questions and Answers Rated A+ How does the reimbursement process change when a patient visits out-of-network providers? When a patient visits an out-of-network provider, they often face higher out-of-pocket costs, and the provider may receive lower reimbursement rates or no direct payment from the insurance company. What happens when a claim is denied due to a lack of medical necessity? If a claim is denied for lacking medical necessity, the pr...

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED 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 patie...

What groups of Americans were largely uninsured when the ACA was being considered? - ANSWER -Unemployed, -Employed with no ESI (employer-sponsored ins) -Young employees -Those who didn't take ESI -Those who chose not to be insured Why didn't the ACA go to a single-payer or an NHI format? What was the Public potion? - ANSWER Each had its own stakeholder with invested interest in continuing their role in the HC system. Allow many to purchase medicaid with means tested premium employers...

Opponents of the government-funded single-payer healthcare system effectively labeled universal healthcare as: correct answers Socialized medicine The labor cost for processing insurance claims will be included as part of the ___ correct answers Actual premium Loading + Pure = Actual In which setting are you most likely to encounter a physician? correct answers Retail clinic If you were a hospital CEO, which form of payment would you prefer? correct answers Retrospective payments based...

Healthcare Financing Correct Ans the system that a society uses to pay for healthcare services. USA does not have a single-payer system like Europe and Canada We have insurance plans which both patients and providers benefit from. (Patient gets a discount while Provider gets reimbursed). Financing increase the demand for service and the supply of professionals. Insurance (Insurer or Underwriter) Correct Ans Protects the insured against risk. Companies do not want to lose money so try to ...