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Exam 2: Introduction to Health Insurance

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Question 21

Multiple Choice

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Which serves as a system of checks and balances for labor and management?

A) health insurance exchange
B) medical underwriter
C) preferred provider organization
D) third-party administrator

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

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Question 22

Multiple Choice

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Which type of insurance has as its goal providing every individual with access to health coverage, regardless of the system implemented to achieve that goal?

A) group health insurance
B) individual health insurance
C) public health insurance
D) universal health insurance

E) A) and C)
F) None of the above

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Question 23

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Which provides health insurance coverage?

Title XIX of the Social Security Amendments of 1965 is a cost-sharing program between the federal and state governments to provide health care services to low-income Americans. It is a government plan known as __________.

Which act resulted in a prospective payment system (PPS) that issues a predetermined payment for inpatient services?

The Investing in Innovations (i2) Initiative is designed to spur innovations in health information technology (health IT) by promoting research and development to enhance competitiveness in the United States. An example of this type of an initiative includes _____.

Which type of health insurance coverage includes federal and state government health programs (e.g., Medicare, Medicaid, SCHIP, TRICARE) that are available to eligible individuals?

Which is a systematic method of documentation that consists of four components: database, problem list, initial plan, and progress notes?

Which legislation protects and compensates railroad workers who are injured on the job?

Which act governs privacy, security, and electronic transactions standards for health care information and was implemented to provide better access to health insurance, limit fraud and abuse, and reduce administrative costs?

Total practice management software is used to generate the electronic medical record, automating which of the following medical practice functions?

The Health Care and Education Reconciliation Act (HCERA) amended the PPACA to implement health care reform initiatives, which included __________.

The Health Information Technology for Economic and Clinical Health Act was included in the American Recovery and Reinvestment Act of 2009 and amended the Public Health Service Act to establish the __________.

The Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) includes a patient classification system that reflects differences in patient __________.

The State Children's Health Insurance Program (SCHIP) was established to provide health assistance to uninsured, low-income children, either through separate programs or through expanded eligibility under state __________ programs.

Which is the amount for which the patient is financially responsible before an insurance policy provides payment?

A lifetime maximum amount is the maximum benefits payable to a __________.

Which provides coverage for catastrophic or prolonged illnesses and injuries?

The Skilled Nursing Facility Prospective Payment System (SNF PPS) was implemented to cover all costs (routine, ancillary, and capital) related to services furnished to Medicare Part A beneficiaries. SNF PPS generates per diem payments for each admission. These payments are case-mix adjusted using a resident classification system called __________.

The CHAMPUS Reform Initiative (CRI) of 1988 resulted in a new program called TRICARE, which includes __________.