Medicare will pay - Study guides, Class notes & Summaries

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...

Practice Test for TExES Health Science (273) Latest 2023 Graded A+ How does Medicaid differ from Medicare medicaid is federally and state-funded What are the two leading causes of death in the US heart disease and cancer The greatest benefit of adopting an electronic medical record system is accessibility of information The migration of educated healthcare providers from rural areas to urban areas or from developing countries to developed countries is brain drain The WHO focuses on? economic...

Georgia Life and Health Insurance Exam Questions and Answers 100% Pass Accident - Correct Answer ️️ -An unplanned unforseen event which occurs suddenly at an unspecified place Accident insurance - Correct Answer ️️ -A type of insurance that protects the insured against loss due to an accidental bodily injury Accidental bodily injury - Correct Answer ️️ -Unplanned unforseen traumatic injury to the body Accidental Death and Dismemberment - Correct Answer ️️ -An insurance po...

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 answersHe 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 several more years at Smallcap, Incorporated. Smallcap has a workforce of15 emplo...

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...

Missouri Life and Health Exam Questions and Answers 100% Pass In a Life insurance contract, an insurance company's promise to pay stated benefits is called the: a) insuring clause b) consideration clause c) entire contract d) owner's rights insuring clause under which circumstance MUST a health insurer have an expedited grievance review procedure? when the enrollee's life or health is jeapordized The Consideration clause in a life insurance contract contains what pertinent information? ...

Texas Nursing Home Administrator Exam Questions and Answers | Latest Version | 2024/2025 | Already Passed "Mental/psychological abuse" is defined as what? Mistreatment within the definition of "abuse" not resulting in physical harm, including, but not limited to, humiliation, harassment, threats of punishment, deprivation, or intimidation. (2) Additional Requirements for facilities or distinct parts of facilities that are certified for Medicare-only participation are in? Chapter 4...

Florida Life and Health Insurance State Exam Review (2-15) Questions and Answers Under Florida Law, which of the following provisions is NOT required in a medicare supplement policy? - Ans: -limitation on pre-existing conditions for up to 12 months M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

LA Life, Health & Accident Insurance Series 103 Practice Exam Questions and Answers Already Passed 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?...