Reference no: EM133105904

1. A benefit plan that provides a less expensive choice for treatment is often a smart way to reduce costs. An example of this type of plan is.

A. requiring higher deductible
B. implementing maximum benefits
C. Allowing the uses of birthing centers
D> Allowing longer Hospital Stays

2. Company x makes sure that it provides HMO coverages as an option in its benefits- selection process. what act would require Company X to do so?

Financial Service Act
American with Disability Act
Health Insurance Portability and Accountability Act
Health Maintenence Organization Act

3. Bev has an HMO that allows her to see a specialist without going through her primary care physician what type of HMO does Bev have?

Direct Access
Closed _panel
Group Model
Staff Model

4. Julio want data to compare the performance of three diffrent managed care plans before he chooses one for his company. which one of the following tools will be most effective for his emaplyees?

Accreditation Accreditation commission
National committee for quality insurance
Joint Commission on Accreditation of Healthcare Organizations
Health plan employer data and information set

5. Which of the following would generally be eligible for coverage as a dependent under a major medical expense plan.

A spouse who is separated but not divorced from the employee
a dependent married child who is 27 years old and a full-time student
a dependent parent who is 66 years old
a dependent, unmarried stepchild who is 18 years old

6. Under which type of HMO arrangements are physicians and other medical personnel employed by another legal entity that has an exclusive contractual relationship with the HMO?

Stagg- model HMO'
Group-model HMO
Individual practice association
Network-model HMO

7. A benefit that does not try to cure a person's ailments, but rather attempts to make a patient comfortable in his or her last days or weeks before death, is called

A home health care
terminal care
extended care
hospice

8. Continental company employed 22 people---14 males and 8 females. According to the model Act, this company would be considered a/a___ employer

Well-balanced
discriminatory
small
growing

9. all of the following are techniques used by HMOs to control medical expenses except

A. Providing treatment on an outpatient basis whenever possible
B. allowing subscribers the option of receiving out of network treatment
C. giving physicians and other care providers a financial incentive to lower costs.
D. encouraging preventative care.

10. In most states, if a woman who's covered by managed care plan believes that she's pregnant, she should first call her.

A. employer, to get preauthorization for care.
B. primary care physician, to make an appointment so that she can be referred to an obstetrician.
C. Managed care plan, to get preauthorization or care
D. Osbsterician, because she doesn't need preauthorization for care

11. Marygoes to the doctor and pays for her visit. when she gets home, she must full out a form and submit it to the insurance company so she can be reimbursed. what type of insurance does she most likey have?

the blues
HMO
POS
indemnity