CPB chapter 2 review Questions and Answers (100% Pass)

CPB chapter 2 review Questions and Answers (100% Pass) Medicare coverage provides hospital coverage and voluntary medical insurance to A.certain individuals of low-income B.persons age 65 or older C.certain disabled individuals under age 65 - Answer️️ -B and C When a patient is enrolled in an HMO, which options below are the responsibilities of the primary care physician (PCP)? I. Manage the member's treatment II. Be the only provider for all of the patient's healthcare III. Provide referrals to specialists IV. Approve emergency department visits V. Provide referrals for inpatient admission - Answer️️ -I,III,V Medicare has 4 parts - which part is responsible for paying hospital claims? - Answer️️ -Part A ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 2 What type of plan allows an insurer to administer straight indemnity insurance, an HMO, or a PPO insurance plans to its members? a. Triple option plan b. Full option plan c. Integrated provider plan d. Management service organization - Answer️️ -a. Triple option plan An insurance plan that provides a gatekeeper to manage the patient's health care is known as a/an PPO HMO IPO Medicaid - Answer️️ -HMO ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 3 A patient is scheduled in your office for Botox injections in her face for her smile lines. She has not met her deductible and states that she is going to use money from her Healthcare Reimbursement Account to pay for it. Is this possible? a. Yes, as long as she has enough money in the account, she may use it for any medical expense she chooses. b. No, cosmetic procedures are ineligible expenses. c. Yes, but only a portion since it is a cosmetic procedure. d. No, because a Healthcare Reimbursement Account cannot be used to meet a deductible. - Answer️️ -b. No, cosmetic procedures are ineligible expenses ACOs are similar to HMOs in that they have shared risks. They do have differences - which statement is TRUE? ACOs requires a five-year commitment Both HMOs and ACOs function as an insurance company. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 4 The ACO is formed with only 5,000 lives instead of HMOs that generally have hundreds of thousands of lives. ACO's are performance based while HMO's are not - Answer️️ -The ACO is formed with only 5,000 lives instead of HMOs that generally have hundreds of thousands of lives Which type of HMO contracts with multiple specialty groups, individual practice groups, and individual physicians? a. Group Model HMO b. Mixed Model HMO c. Network Model HMO d. Hybrid Model HMO - Answer️️ -c. Network Model HMO What does the acronym CHIP stand for? - Ans