HOM 5307 MANAGING HEALTHCARE
ORGANIZATIONS; FINAL TEST (3) 100%
CORRECT.
State mandated benefits laws apply to self-funded employee benefits plans. - ANSWER
False
ERISA applies only to self-funded health plans. - ANSWER False
ERISA requires expedited review for claims involving urgent care. - ANSWER True
State mandated benefits laws apply to self-funded employee benefits plans. - ANSWER
False
ERISA preempts all state laws. - ANSWER False
What is the most significant piece of social legislation since 1965? - ANSWER The
Patient Protection & Affordable Care act of 2010
Critical measures in the contact center include: - ANSWER Abandon rate
Given the low payment rates in Medicaid, there is no interest in developing incentives or
pay for performance programs. - ANSWER False
Consumers and small employers may shop for and purchase health insurance through
the exchange as a result of the children's health insurance reauthorization act of 2009: -
ANSWER False
What is the single largest factor contributing to poor health outcomes? - ANSWER
Poverty
which of the following is the leading reason for member complaints? - ANSWER Claims
issues
The greatest volume of interactions between a health plan and its members will occur
by means of: - ANSWER Telephone
The common reason cited by physicians for limiting their practice to Medicaid
consumers was low reimbursement rates. - ANSWER True
Member services is responsible for what activities? - ANSWER Providing info to
members; Helping members with any problems; Handling member grievances and
ORGANIZATIONS; FINAL TEST (3) 100%
CORRECT.
State mandated benefits laws apply to self-funded employee benefits plans. - ANSWER
False
ERISA applies only to self-funded health plans. - ANSWER False
ERISA requires expedited review for claims involving urgent care. - ANSWER True
State mandated benefits laws apply to self-funded employee benefits plans. - ANSWER
False
ERISA preempts all state laws. - ANSWER False
What is the most significant piece of social legislation since 1965? - ANSWER The
Patient Protection & Affordable Care act of 2010
Critical measures in the contact center include: - ANSWER Abandon rate
Given the low payment rates in Medicaid, there is no interest in developing incentives or
pay for performance programs. - ANSWER False
Consumers and small employers may shop for and purchase health insurance through
the exchange as a result of the children's health insurance reauthorization act of 2009: -
ANSWER False
What is the single largest factor contributing to poor health outcomes? - ANSWER
Poverty
which of the following is the leading reason for member complaints? - ANSWER Claims
issues
The greatest volume of interactions between a health plan and its members will occur
by means of: - ANSWER Telephone
The common reason cited by physicians for limiting their practice to Medicaid
consumers was low reimbursement rates. - ANSWER True
Member services is responsible for what activities? - ANSWER Providing info to
members; Helping members with any problems; Handling member grievances and
