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2. Some benefits under Medicare part A include hospital stays, skilled nursing care, and home health care. True False
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- 2)In 1950, Congress passed bills/ amendments to the Social Security Act of 1935 to create Medicare and Medicaid to provide medical care for millions and improve standards for healthcare facilities. True or false?15. True or False? Medicare only covers people over age 65 whose income is less than 200% of the Federal Poverty Level. O True O False7. Prior to the 2010 Affordable Care Act (ACA), what requirements did the Internal Revenue Service (IRS) impose on tax-exempt hospitals as a condition of maintaining their tax-exempt status A. Provide charity care in the amount that was equal to or greater than the value of the hospital's tax-exempt status B. Provide all of its services to all residents of the community who are unable to pay for their care C. Provide charity care in an amount that was equal to or greater than 3 percent of the hospital's gross revenues in each calendar year D None of the above 8. When a court interprets the meaning of a statute. what is the responsibility of the court? A. To determine the best social policy for addressing the problem raised by the case before court B. To determine and carry out the intent of the legislature that enacted the statute C. To decide the case in accordance with prior decisions of the common lav D. All of the above
- 2. True or False? Privately insured patients have no rights under EMTALA1. Compare and contrast Medicaid and Medicare.25. Marsha works in a hospital billing office. Although she is not participating in it, she is aware of fraud on a large scale aimed at Medicare. Which of the following can Marsha count on if she files a lawsuit on behalf of the government against the hospital and is successful? . She will lose her job. . She will be rewarded with a percentage of the recovery. She can choose to be placed in a witness protection program. . She will receive a promotion.
- 5. After a 75-year-old woman who has had a total hip implant surgery is discharged from the hospital, any therapy services she receives would be covered under. a. Medicaid b. Medicare Part A c. Medicare Part B d. Medicare Part D 6. Which of the following statements about the Patient Protection and Affordable Care Act of 2010 is NOT true? It is a model of socialized, single-payer medicine. It has an individual mandate. a. b. c. It prohibits insurers from discriminating against people because of preexisting conditions. d. It sets minimum standards for health insurance plans.True/False 1. Most people rely on employer-provided health care insurance, for which they pay a portion of the cost, or on government programs to meet essential health care needs. 2. Eliminating the Affordable Care Act would contribute to the federal deficit over the next decade. 3. PPOS differ from HMOS in that enrollees have a financial incentive to use physicians on the preferred list but may opt to see other health professionals at a higher cost. 4. Recent studies suggest that low levels of fitness are not nearly as bad for health and longevity as smoking. 5. Preventive care health plans usually allow regular physical examinations and diagnostic tests; education and training in diet, exercise, and stress management; and smoking cessation programs.1. Define and explain finance and reimbursement 2. What is the Medicare Part A Benefit Period 3. What is Case Mix; What is PDPM (see the Modern Health Care link) 4. What is Value Based Purchasing (Pay for Performance) 5. What is a Spend Down? 6. What is the Community Spouse Resource Allowance?
- Chapter 15 Health Insurance Essentials 323 . A payment method in which providers are paid for each individual enrolled in a plan, regardless of whether the person sees the pro- vider that month, is called a a. capitation b. self-insured managed care d. fee-for-service 10. What should the medical assistant always verify prior to the patient's appointment? a. Eligibility b. Benefits and exclusions plan. Effective date of insurance C. d All of the above WORKPLACE APPLICATIONS 1. After reading the following paragraph, fill the blanks in the statements. The medical assistant's tasks related to health insurance processing are initiated when the patient encounters the provider by appointment, as a walk-in, or in the emergency department or hospital. To complete insurance billing and coding properly, the medical assistant must perform the following tasks: and a. Obtain information from the patient and/or the guarantor, including data. b. Verify the patient's rier or carriers, as well as…1. What is the primary source of legal authority for treating emergency care? a.Statutory b.Regulatory c.Common (case) law d.Constitutional3. Find out and document the procedure and charges to obtain a copy of your own medical record from your primary care physician.