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Exam 2: Introduction to Health Insurance

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Question 31

Multiple Choice

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Which act mandated reporting and disclosure requirements for group life and health plans (including managed care plans) , permitted large employers to self-insure employee health care benefits, and exempted large employers from taxes on health insurance premiums?

A) Employee Retirement Income Security Act of 1974
B) Health Maintenance Organization Assistance Act of 1973
C) Omnibus Budget Reconciliation Act of 1981
D) Tax Equity and Fiscal Responsibility Act of 1982

E) B) and C)
F) A) and D)

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Question 32

Multiple Choice

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Which is the abbreviation for the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 that required implementation of a $400 billion prescription drug benefit, improved Medicare Advantage (formerly called Medicare+Choice) benefits, required faster Medicare appeals decisions, and more?

A) BIPA
B) M-BIPA
C) M-Part-C
D) MMS-BIPA

E) A) and D)
F) A) and B)

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Question 33

Multiple Choice

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The Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) utilizes information from a __________ to classify patients into distinct groups based on clinical characteristics and expected resource needs.

Which includes the identification of disease and the provision of care and treatment to persons who are sick, injured, or concerned about their health status?

Which was introduced in 2000 as a way to encourage individuals to locate the best health care at the lowest possible price with the goal of holding down health care costs?

The primary purpose of the patient record is to provide for __________ of care, which involves documenting patient care services so that others who treat the patient have a source of information to assist with additional care and treatment.

Which currently performs utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries?

Which type of health insurance coverage has costs that are typically less per person and provides broader coverage?

Which documents health care services provided to a patient and includes patient demographic (or identification) data, documentation to support diagnoses and justify treatment provided, and the results of treatment provided?

The Home Health Prospective Payment System (HH PPS) reimburses home health agencies at a __________ rate for health care services provided to patients.

CPT includes a section called Evaluation and Management (E/M) , which describes patient encounters with providers for the purpose of the evaluation and management of __________.

Which classification system was developed by the World Health Organization and used to collect data for statistical purposes?

Which was created by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) to identify and recover improper Medicare payments paid to health care providers under fee-for-service Medicare plans?

Which type of health insurance coverage is purchased by families who do not have access to employer-subsidized coverage?

POR progress notes are documented for each problem assigned to the patient, using the SOAP format. When the patient states, "I have had a stuffy nose and sore throat for about one week," the provider documents the statement in the __________ portion of the progress note.

Large employers who assume the financial risk for providing health care benefits to employees do not pay a fixed premium to a health insurance payer, but establish a trust fund (of employer and employee contributions) out of which claims are paid. This concept is called __________.

Which party signs a contract with a health insurance company and thus, owns the health insurance policy?

Which legislation provides civilian employees of the federal government with medical care, survivors' benefits, and compensation for lost wages?

Which is a global concept that includes the collection of patient information documented by a number of providers at different facilities regarding one patient?