AHIP - FINAL EXAM with tested and verified correct answers 100%.

AHIP - FINAL EXAM with tested and verified correct answers 100%.



AHIP - FINAL EXAM with tested and
verified correct answers 100%.


Correct 141

Incorrect




AHIP - FINAL EXAM with tested and verified correct answers 100%.

,AHIP - FINAL EXAM with tested and verified correct answers 100%.

1 of 141

Definition



receives claims for payment and processes bill
- process, configuration analysts, examiners, processors


bills: mailed or faxed to health plan


processing:
a) electronic billing (claims or IT)
b) automated processing
c) paper claims



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claims dept Case Management




cost-sharing HR dept


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2 of 141

Definition



daily performances at work are guided by policies, procedures,
rules and regulations

AHIP - FINAL EXAM with tested and verified correct answers 100%.

,AHIP - FINAL EXAM with tested and verified correct answers 100%.




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AHIP - FINAL EXAM with tested and verified correct answers 100%.

, AHIP - FINAL EXAM with tested and verified correct answers 100%.

compliance state regulations




statutory requirements appeals


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3 of 141

Definition



- making changes to healthcare delivery system to try to decrease
rate at which spending goes up
- need to grab line moving up, reverse the trend and bend it
downward



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qualified small employer health
Government Rating Process
reimbursement arrangement




bending the heatlhcare cost
cost control methods
curve


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AHIP - FINAL EXAM with tested and verified correct answers 100%.