Admin remed

2 exams in 1

Which of the following can help patients make sure they are receiving the right care, get a ride from home after a procedure or understand the bill?

Patient Advocate

Doctors have the responsibility to help patients understand treatment options and must provide understandable information that meets patient education level and language needs.

True

Electronic Submission of claims is required under what piece of legislation?

Administrative Simplification Compliance Act

Employment based private premiums are subsidized by large tax loopholes, while public premiums are subsidized by general revenues.

True

In practice, which of the following appeals to consumers who do not expect to use much health care and thus do not need to spend their deductible.

High Deductible Health Plan

Per diem creates an incentive to prolong a patient’s stay while providing low intensity, low cost service 

True

The ACA requires the establishment of “exchange” which are

state-based marketplaces where consumers can obtain ACA-compliant health plans

The most commonly cited estimate of the uninsured is from which of the following surveys?

Current Population Survey

The patient’s bill of right was a piece of legislation that was voluntarily adopted by all covered entities and used as a framework by states that passed a state-level bill of rights into law

False

An important system that is maintained by the American Medical Association (AMA) uses what type of codes to identify procedures and services delivered by physicians, hospitals and other providers to treat a patient?

CPT codes

This type of evaluation includes a comparison group and addresses cofounding variables.

Plausibility

To make coverage more affordable for the sickest individuals, the ACA adopted which of the following?

Modified community rating system

Electronic submission of claims is required under the health insurance probability and Accountability Act (HIPAA)

False

Under the Emergency Medical Treatment and Labor Act (EMTAL), a hospital provider must do what an uninsured patient experiencing an emergency?

Stabilize or transfer the patient, but do not restrict providers from billing him or her

Using science to meet a need in the face of economic constraints is known as:

Technical Innovation

What piece of legislation set the minimum standard for health insurance provided by the private industry?

Employee Retirement Income Security Act

What type of codes may be included as part of the CPT/HCPCS coding in order to note unusual circumstances or issues involving the service

Modifier codes

What type of payment works best for well-defined episodes such as surgeries or acute medical conditions but does not work as well for chronic conditions where the beginning and end of the episode are poorly defined

Bundled payment

When a new medicine is developed ______ is a method used to determine the quantity of product that is required to meet customer demand

forecasting

Consumers have the right to negotiate which of the following with the out of network provider and their insurance company and may seek help from a patient advocate in order to avoid exorbitant cost?

Surprise medical bill

Which of the following is a fixed payment to the hospital or healthcare facility based on the patients admitting diagnosis and does not vary with the intensity of service provided?

per admission

What type of health care insurance requires patients to pay more out of pocket before insurance kicks in?

High deductable healthcare

Drug formulary is subject to change during the course of the year?

True

Purpose of Drug formulary is to push patient to the most expensive drug

False

which of the following is used in the first stage of technical innovation to better understand the patient journey

patient flow diagram