Nursing

U.S. Healthcare Insurance, Medicare & Managed Care Mastery Exam: PPO vs HMO vs POS Plans, Gatekeeper Model, Network vs Out-of-Network Coverage, Coinsurance & Copayments, Flexible Spending Accounts (FSA), Health Savings Accounts (HSA), Capitation Payment Models, Revenue Cycle & Claims Processing, Clean Claims vs Denials, Credentialing & Provider Enrollment, National Provider Identifier (NPI), Medicare Parts A B C D, Medicare Advantage Plans, Prescription Drug Coverage, Inpatient vs Outpatient Ser...

HITT Chapter 2 U.S. Healthcare Systems, Policy & Reimbursement Mastery Exam: Continuum of Care, Healthcare Spending Trends, Generalist vs Specialist Ratio, Allied Health Professionals, Licensed Practical Nurses, Registered Nurses Scope & Licensure, Occupational Therapy ADLs, Optometry, Radiologic Technology, Clinical Laboratory Science, Audiology, Physical & Respiratory Therapy, Physician Assistants, Orthopedics & Cardiology Specialties, Acute vs Long-Term Care, Subacute Care, Home Health, Hospi...

U.S. Healthcare & Insurance Mastery Exam: Premiums, Risk Pools, Allowable Charges, Dependent Coverage, Qualifying Life Events, Copayments, Coinsurance, Deductibles, Cost Sharing, Out-of-Pocket Maximums, Prior Authorization, Precertification, Explanation of Benefits, Group Health Insurance Advantages, Individual vs. Family Coverage, Medical Necessity, Utilization Review, Evidence-Based Clinical Guidelines, Managed Care, HMO/PPO/POS/EPO Models, Integrated Delivery Systems, Disease Management, Care...

U.S. Healthcare Reimbursement & Managed Care Mastery Exam: Risk Pools, Premiums, Copayments, Coinsurance, Deductibles, Capitation, Fee-for-Service, Prospective & Retrospective Payments, Episode-of-Care, Policyholder Rights, Covered Conditions & Services, Dependent Coverage, Qualifying Life Events, Maximum Out-of-Pocket, Prior Authorization, Utilization Review, Gatekeepers, Case Management, Evidence-Based Guidelines, Ethical Principles, Nonmaleficence, Beneficence, Autonomy, Medical Identity Thef...

Healthcare Ethics, HIM, and Compliance Exam: Nonmaleficence, Beneficence, Autonomy, Ethical Dilemmas, Personal Cultural Competence, Cultural Audits, Equal Employment Opportunity Commission, Receipt of Breach Notice, Protected Health Information (PHI), Medical Identity Theft, Ethics Committees, Explanation of Benefits Review, Retrospective Documentation, Need-to-Know Principle, Unbundling, Up-Coding, Double Billing, Institutional Review Boards (IRB), Belmont Report, Query the Physician, Informed ...

HIT 210 HC Reimbursement Ch5 Managed Care and Integrated Delivery Systems Exam: Service Management Tools, Carve-Out Contracts, Disease Management, Evidence-Based Clinical Practice Guidelines, Subcapitation, Physician Incentives, Medicare and Medicaid Physician Incentive Rules, Utilization Review, Preadmission Review, Precertification, Gatekeeper Roles, Primary Care Provider Functions, Staff, Group, and Hospital-Led HMOs, PPOs, POS Plans, IDS Models, Out-of-Network Cost Sharing, Medical Necessity...

U.S. Healthcare Reimbursement & Insurance Exam: Revenue Cycle Management, Provider and Third-Party Payer Transactions, First-Second-Third Party Roles, Multidisciplinary Models, Risk Pools, Adverse Selection, Policyholders, Beneficiaries, Guarantors, Premiums, Deductibles, Coinsurance, Copayments, Cost-Sharing Provisions, Maximum Out-of-Pocket, Covered Services, Covered Conditions, Medically Necessary Care, Prudent Layperson Standard, Prior Authorization, Precertification, Coordination of Benefit...

HIM 400 Ch. 2 U.S. Health Insurance & Managed Care Exam: Individual Health Insurance, Employer-Based Coverage, HSAs, FSAs, HRAs, Risk Pools, Adverse Selection, Policyholders, Beneficiaries, Premiums, Cost-Sharing Provisions, Deductibles, Copayments, Coinsurance, Tiered Benefits, Covered Conditions, Exclusions, Medically Necessary Care, Prudent Layperson Standard, Eligibility, Guaranteed Issue, Waiting Periods, Enrollment, Open Enrollment, Special Enrollment Periods, Qualifying Life Events, Benef...

U.S. Healthcare Reimbursement & Insurance Exam: Reimbursement, Revenue Cycle Management, Premiums, Risk Pools, Third-Party Payers, Policyholders, Beneficiaries, Guarantors, Providers, Payors, Fee Schedules, Cost-Sharing, Deductibles, Coinsurance, Copayments, Managed Care, HMO, PPO, POS, ACA, Guaranteed Issue, Enrollment Periods, Qualifying Life Events, Benefits, Essential & Special Limited Benefits, Hospital & Surgical Policies, Major Medical, Catastrophic Coverage, Disability Income Protection,...

HIT 210 US Healthcare Reimbursement & Insurance Exam: Fee-for-Service, Capitated Payments, Episode of Care, Global & Per Diem Payments, PM-DRGs, APR-DRGs, IR-DRGs, PCGs, RBRVS, UCR, Fee Schedules, Managed Care, Medicare, Workers’ Compensation, Third-Party Payers, Remittance Advice, Allowable Fees, Prospective & Retrospective Payment Methods, Financial Risk, Actuarial Pooling, Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Patient Claims, Reimbursement Systems...