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

California Life, Accident, and Health Insurance Final Exam Questions and Answers Already Passed What distinguishes a deferred annuity from an immediate annuity? The time at which benefit payments start Cindy buys a 10-year certain annuity with an installment refund. After receiving monthly payments for 5 years, Cindy dies. How many remaining payments will the insurer make to her beneficiary? 60 payments What is a common reason people purchase an annuity? To protect against the risk of outlivin...

Fundamentals CMS Midterm Terms in this set (200) A nurse is assessing the heart sounds of a client who has developed chest pain that becomes worse with inspiration. The nurse auscultates a high- pitched scratching sound during both systole and diastole with the diaphragm of the stethoscope positioned at the left sternal border. Which of the following heart sounds should the nurse document? A. Audible Click B. Murmur C. Third heart sound D. Pericardial friction rub A nurse is obtaining ...

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 ...

Exam 3: NUR204/ NUR 204 (Latest 2024/ 2025 Update) Leadership & Management| Review with Questions and Verified Answers| 100% Correct| Grade A – Fortis Q: what is a PPO plan? Answer: -person can use a doc that is provided or that have to pay extra Q: what is a HMO plan? Answer: -pt picks a PCP and the PCP will refer you to a specialist Q: method of reimbursement where medicare payment is based on a predetermined fixed amount Answer: prospective payment system ...

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...

HFMA: Healthcare Financial Management Association Exam (2024 / 2025) Questions and Verified Answers 1. Which of the following options is an alternative to valid long-term payment plans? ~ Answer: Bank loans 2. What type of plan restricts benefits for nonemergency care to approved providers only? ~ Answer: A PPO (preferred provider organization) plan 3. What does scheduling allow provider staff to do? ~ Answer: Review the appropriateness of the service requested 4. When an adult patient is covere...

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...

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...

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 ...

ATI Content Mastery Series (RN Concept-Based Assessment) Questions With 100% Correct Solutions. A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (Select all that apply.) A. Home health care B. Rehabilitation facilities C. Diagnostic centers D. Skilled nursing facilities E. Oncology centers A, B, D - Correct: Restorative health care involves intermediate follow-up care for restoring heal...