HIMS 5620 EXAM 1 | QUESTIONS AND
ANSWERS | LATEST UPDATE | WITH COMPLETE
SOLUTION
premium - ANSWERS-the amount of money that a policyholder or
beneficiary must periodically pay an insurance company in return for
healthcare coverage
risk pool - ANSWERS-group of individual entities, such s individuals,
employers, or associations whose healthcare costs are combined for
evaluating financial history and estimating future costs
policyholder - ANSWERS-individual or entity that purchases health
insurance coverage
beneficiary - ANSWERS-an individual who is eligible for benefits from a
health plan
guarantor - ANSWERS-person responsible for the patient's health costs
revenue integrity - ANSWERS-performing revenue cycle duties to obtain
operational efficiency, compliance adherence, and legitimate reimbursement
goals to producing a claim - ANSWERS-clean - free of errors
complete - all services and supplies reflected
compliant - adhering to contract requirements, regulations, and laws
integrated revenue cycle (IRC) - ANSWERS-the coordination of revenue
cycle activities under a single leadership and team structure
, reimbursement - ANSWERS-amount paid to a healthcare provider for
services provided to a patient
revenue cycle - ANSWERS-regular set of tasks and activities that produces
reimbursement (revenue)
revenue cycle management (RCM) - ANSWERS-the supervisor of all the
administrative and clinical functions that contribute to the capture,
management, and collection of patient service reimbursement
insurance - ANSWERS-a system of reducing a person's exposure to risk of
loss by having another party, an insurance company, assume the risk
three national models for delivering healthcare services - ANSWERS-social
insurance, national health insurance, private health insurance
social insurance model (Bismark model) - ANSWERS-universal healthcare
coverage for a set of benefits defined by the government, which may include
preventative and primary care, hospitalization, mental health benefits, and
prescription drugs
every worker and employer must contribute to sickness funds who
redistribute the money per government regulations (form of social security)
the amount contributed is based on income
national health service model (Beveridge model) - ANSWERS-single-payer
health system
ANSWERS | LATEST UPDATE | WITH COMPLETE
SOLUTION
premium - ANSWERS-the amount of money that a policyholder or
beneficiary must periodically pay an insurance company in return for
healthcare coverage
risk pool - ANSWERS-group of individual entities, such s individuals,
employers, or associations whose healthcare costs are combined for
evaluating financial history and estimating future costs
policyholder - ANSWERS-individual or entity that purchases health
insurance coverage
beneficiary - ANSWERS-an individual who is eligible for benefits from a
health plan
guarantor - ANSWERS-person responsible for the patient's health costs
revenue integrity - ANSWERS-performing revenue cycle duties to obtain
operational efficiency, compliance adherence, and legitimate reimbursement
goals to producing a claim - ANSWERS-clean - free of errors
complete - all services and supplies reflected
compliant - adhering to contract requirements, regulations, and laws
integrated revenue cycle (IRC) - ANSWERS-the coordination of revenue
cycle activities under a single leadership and team structure
, reimbursement - ANSWERS-amount paid to a healthcare provider for
services provided to a patient
revenue cycle - ANSWERS-regular set of tasks and activities that produces
reimbursement (revenue)
revenue cycle management (RCM) - ANSWERS-the supervisor of all the
administrative and clinical functions that contribute to the capture,
management, and collection of patient service reimbursement
insurance - ANSWERS-a system of reducing a person's exposure to risk of
loss by having another party, an insurance company, assume the risk
three national models for delivering healthcare services - ANSWERS-social
insurance, national health insurance, private health insurance
social insurance model (Bismark model) - ANSWERS-universal healthcare
coverage for a set of benefits defined by the government, which may include
preventative and primary care, hospitalization, mental health benefits, and
prescription drugs
every worker and employer must contribute to sickness funds who
redistribute the money per government regulations (form of social security)
the amount contributed is based on income
national health service model (Beveridge model) - ANSWERS-single-payer
health system
