health insurance pt 2

COMPLETE CORRECT ANSWERS FOR QUESTIONS 11-2011.   People who receive MedicareA. are never eligible to receive Medicaid.B. may be eligible to receive Medicaid if they meet the age requirement.C. may be eligible to receive Medicaid coverage.D. can combine Medicare with TRICARE.12.   Ralph is assigning diagnosis and procedure codes for a 35-year-old patient from New Mexico, who has hypertension and end-stage renal disease. Would this patient qualify for Medicare?A. Yes, because the patient has end-stage renal diseaseB. No, because the patient resides in New MexicoC. No, because the patient is under age 65D. Yes, because the patient has hypertension13.   The first prepaid health insurance plans in the United States wereA. TRICARE and workers’ compensation.B. CHAMPUS and CHAMPVA.C. Blue Cross and Blue Shield.D. Medicare and Medicaid.14.   Which of the following is the largest privately underwritten health insurance contract in the world?A. Harless programB. SCHIPC. Federal Employee Program (FEP)D. CHAMPVA program15.   A provider is classified as a/anA. biller who submits claims to insurance carriers.B. coder who provides medical record data.C. individual or group of individuals that provide a health care service.D. beneficiary that provides information for insurance coverage.16.   Tom is billing an emergency room visit for a Medicaid patient who’s being seen for a wellness visit. Which one of the following statements is true as a result of the Balanced Budget Act?A. There are new surgical treatments available.B. No new applications are required for TAFT recipients.C. Patients have expanded preventive-care benefits.D. There are new standards for TRICARE.17.   Dr. Singer is working within a reimbursement system in which the insurance is billed after all the treatment has been given to the patients. What is the main reason that the doctor orders more tests, exams, and procedures under this system?A. Fear of being suedB. To increase resource utilizationC. To make a profitD. Because no one has to pay for it18.   With a PPO, the beneficiary has the ability toA. choose a hospital within a 50-mile radius only.B. choose a physician or hospital from the designated provider list.C. select a dentist within a 10-mile radius.D. select an add-on policy for supplemental unemployment benefits19.   Physician-hospital organizations (PHOs) are also called _______ organizations.A. medical staff-hospitalB. health managementC. individual providerD. preferred provider20.   Mrs. Fang is a 72-year-old retired school teacher who has been hospitalized for pneumonia. What type of insurance is most likely being used to pay for her hospital stay?A. Medicare Part DB. Medicare Part BC. Medicare Part AD. Medicare Part C

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