Savings providers - Study guides, Class notes & Summaries

Health Insurance Exam-Illinois Questions and Answers 100% Pass What is a health insurance policy? A health insurance policy is a contract between an insurer and the insured that outlines the terms of coverage, including benefits, costs, and exclusions. What does the term "network" refer to in health insurance? A network refers to a group of healthcare providers that have agreed to provide services at negotiated rates for an insurance plan's members. What are essential health...

Broad view of Employee Benefits - Answer- This view sees employee benefits as virtually any form of compensation other than direct wages. Components of the Broad view of Employee Benefits - Answer- 1. Employer's share of legally required payments (Social Security and Medicare, unemployment insurance, and worker's compensation benefits) 2. Payments for time not worked (e.g. paid rest periods, paid sick leave, paid vacations, holidays, parental leave, etc). 3. Employer's share of medical ...

Healthcare Reimbursement Chapters 8+ Latest Version Already Passed How do insurance plans typically categorize services for reimbursement? Insurance plans categorize services based on various criteria such as type of care, urgency, and medical necessity, influencing the coverage and reimbursement rates. What role does the Medicare Severity Diagnosis Related Groups (MS-DRGs) play in reimbursement? MS-DRGs classify hospital cases into groups that are expected to have similar hospi...

Accountable Care Organization (ACO) - Answer-An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee-for-service program Purpose: improve delivery of care and save costs Coordination of care Shared Savings Program - Answer-ACO payment is made for participants under fee for service who meet performance standards while lowering costs advance payment model - Answer-ACO a suppl...

Accountable care organization - correct answer Population based model for healthcare allowable charge - correct answer Amount the payer will reimburse providers for the service Attribution - correct answer Assignment of a beneficiary to particular organization Billed charges - correct answer Amount the provider is actually charging for a service Giant ACO has agreed to a shared savings rate of 65 percent and a shared loss rate of 40 percent with CMS. Giant ACO participates in a _____...

Indiana Navigator Exam Questions and Answers Already Passed Auto Assignment the process by which an individual who does not select a Hoosier Healthwise (HHW) or HIP Managed Care Entity (MCE) at the time of the HHW or HIP application, or within 14 days of the submission of the application, is automatically assigned to a Managed Care Entity (MCE) Certificate of Coverage a list of benefits, services, cost sharing, exclusions, and limits applied by a particular health insurance policy. ...

Test Bank For Foundations for Population Health in Community Public Health Nursing 5th Edition by Marcia Stanhope, Jeanette Lancaster Chapter 1-32 Complete Guide A+ Test Bank For Foundations for Population Health in Community Public Health Nursing 5th Edition Authors: Authors: Marcia Stanhope, Jeanette Lancaster Table of Contents Chapter 1. Community and Prevention Oriented Practice to Improve Population Health Chapter 2. The History of Public Health and Public and Community Health Nursing Chapt...

Primary Care Interprofessional Collaborative Practice 6th Edition Buttaro Test Bank. Chapter 01: Interprofessional Collaborative Practice: Where We Are Today Buttaro: Primary Care: A Collaborative Practice, 6th Edition NURSINGTB.COM MULTIPLE CHOICE 1. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 ACO. What is part of this designation? a. Bonuses based on achievement of benchmarks b. Care coordination for chronic diseases c. Stand...

Medical billing and coding latest version graded A+ Medical Insurance Financial plan (the payer) that covers the cost of hospital and medical care Policyholder Person who buys an insurance plan; the insured, subscriber, or guarantor Health Plan Individual or group plan that provides or pays for the cost of medical care Benefits What a health plan pays for services covered in an insurance policy; listed in the schedule of benefits. Medical Necessity Reasonable services of prov...

Select all that apply Providers of venture capital are: Multiple select question. savings banks wealthy individuals the Federal Reserve Bank mature corporations looking for new technology pension funds specialist venture capital firmswealthy individuals mature corporations looking for new technology pension funds specialist venture capital firms