When a provider receives a fixed amount to provide only the care that an individual needs from the provider, this is known as a _____________ payment.
capitation
fixed
premium
sub-capitation
4 points
Question 2
The healthcare industry is heavily regulated by ____ and ____ legislation.
city; local
state; city
county; state
federal; state
4 points
Question 3
When a patient signs a release of medical information at a physician’s office, that release is generally considered to be valid
for six months
for a single visit to the physician
for one year from the date entered on the form
until the patient changes insurance companies
4 points
Question 4
When the provider is required to receive as payment in full whatever amount the insurance reimburses for services, the provider is agreeing to
accept assignment
assignment of benefits
authorize services
coordination of benefits
4 points
Question 5
Which document is used to guarantee the patient’s financial and medical record?
encounter form
patient insurance form
patient ledger
patient registration form
4 points
Question 6
The person responsible for paying the charges for services rendered by the provider is the
beneficiary
guarantor
guardian
subscriber
4 points
Question 7
Which federal legislation was enacted in1995 to restrict the referral of patients to organizations in which providers have a financial interest?
Federal Anti-Kickback Law
Hill-Burton Act
HIPAA
Stark II laws
4 points
Question 8
The recognized difference between fraud and abuse is the
cost
intent
payer
timing
4 points
Question 9
The specified amount of annual out-of-pocket expenses for covered health care services that the insured must pay annually for health care is called the
coinsurance
copayment
deductible
premium
4 points
Question 10
Which three components constitute the RBRVS payment system?
fee schedule, practice expense, and malpractice expense
physician work, practice expense, and geographical location
physician work, practice expense, and malpractice insurance espense
practice expense, malpractice insurance expense, and liability insurance expense
4 points
Question 11
Mandates are
directives
laws
regulations
standards
4 points
Question 12
Which type of HMO offers subscribers health care services by physicians who remain in their individual office setting?