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Healthcare Management: An Introduction

Last Update Nov 24, 2024
Total Questions : 367

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Healthcare Management: An Introduction Questions and Answers

Questions 1

Medicare Part C can be delivered by the following Medicare Advantage plans:

Options:

A.

HCCP, HMO, PPO (local or regional), PFFS or MSA.

B.

CCPs, PFFS or MSA.

C.

HMO, HSA, PPO (local or regional), PFFS or MSA.

D.

HMO, PPO (local or regional), POS, or MSA.

Questions 2

Katrina Lopez is a claims analyst for a health plan that provides a higher level of benefits for services received in-network than for services received out-of-network. Ms. Lopez reviewed a health claim for answers to the following questions:

Question A -

Options:

A.

A, B, C, and D

B.

A, B, and D only

C.

B, C, and D only

D.

A and C only

Questions 3

One of the most influential pieces of legislation in the advancement of managed care within the United States was the HMO Act of 1973. One provision of the HMO Act of 1973 was that it

Options:

A.

emphasized compensating physicians based solely on the volume of medical services they provide

B.

exempted HMOs from all state licensure requirements

C.

established a process under which HMOs could elect to be federally qualified

D.

required federally qualified HMOs to relate premium levels to the health status of the individual enrollee or employer group