health insurance pt 2
COMPLETE CORRECT ANSWERS FOR QUESTIONS 11-20 ; ;11. ; ;People who receive Medicare ; ; ; ; ; ; ; ;A. ;are never eligible to receive Medicaid. ; ; ;B. ;may be eligible to receive Medicaid if they meet the age requirement. ; ; ;C. ;may be eligible to receive Medicaid coverage. ; ; ;D. ;can combine Medicare with TRICARE.
;12. ; ;Ralph is assigning diagnosis and procedure codes for a 35-year-old patient from New Mexico, who has hypertension and end-stage renal disease. Would this patient qualify for Medicare? ; ; ; ; ; ; ; ;A. ;Yes, because the patient has end-stage renal disease ; ; ;B. ;No, because the patient resides in New Mexico ; ; ;C. ;No, because the patient is under age 65 ; ; ;D. ;Yes, because the patient has hypertension
; ; ;13. ; ;The ;first ;prepaid health insurance plans in the United States were ; ; ; ; ; ; ; ;A. ;TRICARE and workers’ compensation. ; ; ;B. ;CHAMPUS and CHAMPVA. ; ; ;C. ;Blue Cross and Blue Shield. ; ; ;D. ;Medicare and Medicaid.
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; ; ;14. ; ;Which of the following is the largest privately underwritten health insurance contract in the world? ; ; ; ; ; ; ; ;A. ;Harless program ; ; ;B. ;SCHIP ; ; ; ;C. ;Federal Employee Program (FEP) ; ; ;D. ;CHAMPVA program
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; ; ;15. ; ;A provider is classified as a/an ; ; ; ; ; ; ; ;A. ;biller who submits claims to insurance carriers. ; ; ;B. ;coder who provides medical record data. ; ; ;C. ;individual or group of individuals that provide a health care service. ; ; ;D. ;beneficiary that provides information for insurance coverage.
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; ; ;16. ; ;Tom is billing an emergency room visit for a Medicaid patient who’s being seen for a wellness visit. Which one of the following statements is ;true ;as a result of the Balanced Budget Act? ; ; ; ; ; ; ; ;A. ;There are new surgical treatments available. ; ; ;B. ;No new applications are required for TAFT recipients. ; ; ;C. ;Patients have expanded preventive-care benefits. ; ; ;D. ;There are new standards for TRICARE.
;17. ; ;Dr. Singer is working within a reimbursement system in which the insurance is billed after all the treatment has been given to the patients. What is the ;main ;reason that the doctor orders more tests, exams, and procedures under this system? ; ; ; ; ; ; ; ;A. ;Fear of being sued ; ; ;B. ;To increase resource utilization ; ; ;C. ;To make a profit ; ; ;D. ;Because no one has to pay for it
; ; ;18. ; ;With a PPO, the beneficiary has the ability to ; ; ; ; ; ; ; ;A. ;choose a hospital within a 50-mile radius only. ; ; ;B. ;choose a physician or hospital from the designated provider list. ; ; ;C. ;select a dentist within a 10-mile radius.
; ; ;D. ;select an add-on policy for supplemental unemployment benefits
; ;19. ; ;Physician-hospital organizations (PHOs) are also called _______ organizations. ; ; ; ; ; ; ; ;A. ;medical staff-hospital ; ; ; ;B. ;health management ; ; ; ;C. ;individual provider ; ; ; ;D. ;preferred provider ;
; ; ;20. ; ;Mrs. Fang is a 72-year-old retired school teacher who has been hospitalized for pneumonia. What type of insurance is ;most ;likely being used to pay for her hospital stay? ; ; ; ; ; ; ; ;A. ;Medicare Part D ; ; ;B. ;Medicare Part B ; ; ;C. ;Medicare Part A ; ; ;D. ;Medicare Part C