Claims administrator - Study guides, Class notes & Summaries
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Arizona Life Insurance Exam Questions and Answers (Latest Update 2023) Verified Answers
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Arizona Life Insurance Exam 
Questions and Answers 
(Latest Update 2023) 
Verified Answers 
a whole life policy that provides a choice of dividend options include the 
following statement about dividends they accrue at a guaranteed rate 
they are deferred for one year they are not guaranteed they are guaranteed 
after the first year - Correct Answers they are not guaranteed 
When there is a named beneficiary on a life insurance policy, the death 
benefits 
1. are directed to a trustee ...
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QME Exam Questions and Answers Already Passed
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QME Exam Questions and Answers 
 
Already Passed 
 
Which types of reports are typically used in evaluations? 
Initial (Comprehensive) 
 
Subsequent (Follow-up) 
 
Additional (Supplemental) 
 
What is a factual correction report? 
A factual correction report is a specific type of supplemental report focused exclusively on 
reviewing the medical records that were available during the evaluation. 
 
When can a factual correction request be made for unrepresented workers? 
Such requests can be made...
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 
Steps used to control costs of managed care include: 
Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
 
 
 
DRG is used to classify 
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 
HMO 
Conventional 
PPO and POS 
H...
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CSPR - Certified Specialist Payment Rep (HFMA) Exam 2023 with Complete Solutions
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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...
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FDLE SOCE Review Exam Questions With Correct Answers Latest 2023/2024 (100% Correct)
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FDLE SOCE Review Exam Questions With Correct Answers Latest 2023/2024 (100% Correct). A correctional probation officer is responsible for: - ANSWER-• performing professional 
work to investigate and assess offenders 
• ensuring that offenders comply with any statutory or special conditions of supervision 
ordered by the sentencing authority 
• evaluating offender progress and making recommendations throughout the period of 
supervision 
• assisting offenders in securing employment and ma...
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Medical Office Administration Questions and Answers Already Passed
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Medical Office Administration Questions 
 
and Answers Already Passed 
 
How do medical office administrators handle patient billing and insurance claims? 
 
Medical office administrators process billing by generating invoices, submitting insurance 
claims, and following up on unpaid claims or denied charges. 
 
What are the key elements to include in a patient’s medical record? 
 
Key elements include personal information, medical history, treatment plans, progress notes, 
and results from di...
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Florida 3-20 Public Adjuster Exam Outlines Latest 2023 Rated A+
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Florida 3-20 Public Adjuster Exam Outlines Latest 2023 Rated A+ 
There are several important statutory requirements pertaining to contracts made by public adjusters: Must state the type of claim, including an emergency claim, non-emergency claim or supplemental claim. Requires the signatures of all named insureds. If the signatures of all named insureds are not available, the public adjuster must submit an affidavit signed by the available named insureds attesting that they have authority to ent...
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2-15 Florida Insurance Practice Exam Study Questions and Answers with Verified Solutions 2024
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An organization outside the members of a self-insurance group which, for a fee, processes claims, completes benefits paperwork and often analyzes claims information is known as the: 
 
 
1) primary administrator (PA). 
2) second-party administrator (SPA) 
3) third party administrator (TPA) 
4) administrator. -Correct Answer 
 
According to the NAIC Model Health Insurance Policy Provisions, under the _________________________ provision, the insurer is prohibited from denying a claim on the basis...
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ALF Core Test Questions and Answers (Latest 2023 — 2024) With Complete Solution
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What is the penalty, if a community fails to report that they are declaring bankruptcy, foreclosure or facing eviction? - Considered a 2nd degree MISDENIEANOR 
Where should resident funds and property be held for safekeeping? - in a Florida banking institution. 
A POA, Power of Attorney is also called... - an Attorney-in-Fact 
Who/ what is considered a controlling interest of an ALF? - Anyone or entity that holds 5% or more ownership interest in the community. 
When a controlling interest is in...
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AINS 21 Segment B (Chapters 4-6) Rated A+
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claim a demand by a person or business seeking to recover from an insurer for a loss that 
may be covered by an insurance policy 
claimant anyone who submits a claim to an insurer 
first party the insured in an insurance contract 
third party a person or business who is not a party to the insurance contract bu who asserts a 
claim against the insured 
claim representative (or adjuster) a person responsible for verifying coverage, determining 
the cause of loss, determining the amount of damages ...
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AIC 30 Latest Update with Verified Solutions
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AIC 30 Latest Update with Verified 
 
Solutions 
 
First Party Focus Coverage and Amount of damage 
 
Second Party Insurance Company 
 
First Party Insured 
 
Third Party Claimant 
 
Third Party Focus Liability, Coverage, and Amount of damage 
 
Third Party Administrator (TPA) an organization that provides admin services associated 
with risk financing and insurance. They handle claims and risk management for self-insured 
organizations 
 
Independent Adjuster handles claims for the insurer for ...
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