Midterm - 1265 Questions with complete solution 2023/2024

Midterm - 1265 Questions with complete solution 2023/2024 In the US, what is health insurance? - correct answer Reduction of a person's or a group's exposure to risk for unknown healthcare costs by the assumption of that risk by an entity Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for spinal fusion was canceled after the patient was diagnosed with mononucleosis. On today's visit, the patient is started on prednisone for severe sore throat and difficulty swallowing. The patient was accompanied by his parents who have health insurance through the mother's employment at the State Department of Treasury. Who is the second party in this healthcare reimbursement scenario? - correct answer Dr. Gilbert Which of the following is not a principle of revenue integrity? - correct answer No oversight Dr. Gilbert sees a 14-old-male with adolescent idiopathic thoracic scoliosis. Surgery for spinal fusion was canceled after the patient was diagnosed with mononucleosis. On today's visit, the patient is started on prednisone for severe sore throat and difficulty swallowing. The patient was accompanied by his parents who have health insurance through the mother's employment at the State Department of Treasury. Who is the third party in this healthcare reimbursement scenario? - correct answer Insurance Company An employee paying for 40 percent of the insurance premium through payroll processing is an example of a transaction between ________ and ________. - correct answer Patient; employer Why do health insurers pool premium payments for all the insureds in a group and use actuarial data to calculate the group's premiums? - correct answer T