Hmo - Study guides, Class notes & Summaries
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AHIP 2025 Final Exam Questions and Answers (2024 / 2025) (Verified Answers)
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AHIP 2025 Final Exam Questions and Answers (2024 / 2025) (Verified Answers).1.	PPO, HMO, MSA, Cost Plan, PFFS 
ANS Types of Medicare Advantage Plans 
2.	Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles 
ANS Medicare-Medicaid plans 
3.	Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coin- surances and deuctibles. Different enr...
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Florida All Lines Claims Adjuster Exam 2024 | Questions with 100% Correct Answers | Verified | Updated 20242025
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What is an eligible building for flood insurance?: A structure with 2 or more outside rigid walls and a fully secure roof, built on a permanent site, with 50% or more of the value above ground level and located within an eligible community 
What is Builders Risk Coverage?: Covers buildings in the course of completion. Proper coverage is 100% of expected completed value 
Do all Homeowners policies contain Coverage A?: No, HO-4 (Renters person- al property) 
What is casual labor in workers' compen...
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CSPR - Certified Specialist Payment Rep (HFMA) questions with correct answers
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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 s...
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FLORIDA 2-15 INSURANCE LICENSE EXAM ACTUAL UPDATE WITH LATEST ONLINE WRITTEN EXAM QUESTIONS AND ANSWERS NEW UPDATE
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FLORIDA 2-15 INSURANCE LICENSE EXAM ACTUAL UPDATE WITH LATEST ONLINE WRITTEN EXAM QUESTIONS AND ANSWERS NEW UPDATE 
 
Accumulation units are converted into annuity units: 
 
A group life insurance plan in which the employer pays the entire premium is known as a ________________ plan. 
 
If a disabled worker covered under Social Security disability benefits recovers and then is disabled again within five years, a new waiting period is required before benefits begin again. 
 
Robert had an accid...
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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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TEST BANK OF ENDODONTICS PRINCIPLES AND PRACTICE 6th EDITION by Mahmoud Torabinejad and Ashraf F. Fouad
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TEST BANK OF ENDODONTICS PRINCIPLES AND PRACTICE 6th EDITION by Mahmoud Torabinejad and Ashraf F. Fouad 
 
1.Which of the following is a condition that can be described as irreversible pathosis of the pulp: 
a.Dentin hypersensitivity 
b.Pulp canal obliteration (total calcification) 
c.Internal resorption 
d.Sharp, brief pain with thermal changes 
 
2.The following inflammatory mediator(s) is/are not elevated in the pulp, in cases with symptomatic irreversible pulpitis: 
a.Prostaglandins 
b.Leuko...
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ATI RN Maternal Newborn 1.	A nurse is caring for a client who has uterine atony and is experiencing postpartum hemorrhage. Which of the following actions is the nurse’s priority? •	Massage the client’s fundus Uterine atony and postpartum hmorrhage indica
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ATI RN Maternal Newborn 
1.	A nurse is caring for a client who has uterine atony and is experiencing postpartum hemorrhage. Which of the following actions is the nurse’s priority? 
•	Massage the client’s fundus 
Uterine atony and postpartum hmorrhage indicate that this 
client is at the greatest risk for hypovolemic shock. This can compromise the client’s vital organs, which can lead to death. Therefore, the nurse’s priority is to massage the client’s fundus to minimize blood loss. ...
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Principles of Economics, 2nd Australian Edition, 2e Joseph Stiglitz, Carl Walsh, Jeffrey Gow, Ross Guest, William Richmond, Max Tani (Test Bank)
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Principles of Economics, 2nd Australian Edition, 2e Joseph Stiglitz, Carl Walsh, Jeffrey Gow, Ross Guest, William Richmond, Max Tani (Test Bank) 
 
Principles of Economics, 2nd Australian Edition, 2e Joseph Stiglitz, Carl Walsh, Jeffrey Gow, Ross Guest, William Richmond, Max Tani (Test Bank)
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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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Kentucky Life and Health Insurance Exam (New 2024/ 2025 Update) Questions and Verified Answers| 100 % Correct| Grade A
- Exam (elaborations) • 51 pages • 2024
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Kentucky Life and Health Insurance Exam 
(New 2024/ 2025 Update) Questions and 
Verified Answers| 100 % Correct| Grade A 
 
 
QUESTION 
 The only party in an insurance contract that makes a legally enforceable promise is the 
insurance company. Because of this, insurance contracts are considered to be: 
 
 conditional 
 aleatory 
 unilateral 
 contracts of adhesion 
 
 
Answer: 
unilateral 
 
Insurance contracts are unilateral. This means that only one party (the insurer) makes any kind of ...
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ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT)
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ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) 
ALABAMA INSURANCE TEST QUESTIONS & ANSWERS (100% CORRECT) 
 
Which welfare program provides assistance to the needy? - ANSWER - Medicaid 
 
Barbara has the right to change the beneficiary designation on her life insurance policy. Barbara's beneficiary is a(n): - ANSWER - revocable beneficiary 
 
Within how many calendar days must all clean electronic health insurance claims be paid in Alabama? - ANSWER - 30 
 
Which type of term policy ...
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