Could someone please check my answers for me..Thanks
1. Mary needs Medicaid coverage. Where should she start looking for information to determine her eligibility?
A. The local hospital social services department
B. Her employer
C. The federal government website
D. The state in which she lives
I chose D.
2. You're a physician who wants to join together with other HMO physicians but not give up your individual pracice. The best choice for you may be a/an
A. integrated delivery system
B. preferred provider organization
C. independent practice association
D. primary care physician practice
I chose C.
3. You started working for a private insurance company before the inception of managed care. You've been talking with your co-worker about how different reimbursement was in the past. You commented that before managed care, your employer reimbursed providers on a
A. prospective basis
B. retrospective, fee-for-service basis
C. cash-benefit basis
D. medically needy basis
I chose B.
4. Your niece may be eligible for health care coverage under the State Children's Health Insurance Program. Where should your niece first start reviewing eligibility requirements?
A. Social Services
B. Place of employment
C. In the state where she resides
D. The Centers for Medicare and Medicaid Services
I chose D.
5. You own a company in a state where state funds aren't mandated for employee health insurance. What's one option for providing your employees with health care coverage for work-related injuries?
A. Medicaid plans
B. Referrals to other network groups
C. Medical savings plans
D. Self-insurance coverage
I chose C.
Please!
Its
D
C
B
C
C
1. To determine eligibility for Medicaid coverage, Mary should start looking for information from the state in which she lives (option D). The state government is responsible for administering Medicaid programs, determining eligibility criteria, and providing information about the application process. Mary can visit the state's official website or contact the local Medicaid office to gather information on eligibility requirements, application procedures, and available benefits.
2. If you're a physician who wants to join together with other HMO physicians while retaining your individual practice, the best choice for you may be an independent practice association (option C). An independent practice association (IPA) allows individual physicians to maintain their own practices while being part of a network that negotiates contracts with managed care organizations. This model allows physicians to retain some autonomy while benefiting from the advantages of collective bargaining and shared resources.
3. If you started working for a private insurance company before the inception of managed care and you're discussing how reimbursement was different in the past, you commented that your employer reimbursed providers on a retrospective, fee-for-service basis (option B). Before the introduction of managed care, providers were typically reimbursed based on the actual services they provided, after the services were rendered. This reimbursement model is known as retrospective fee-for-service, as opposed to prospective payment systems that define payment rates in advance based on the expected cost of care.
4. If your niece may be eligible for health care coverage under the State Children's Health Insurance Program (SCHIP), the first step to review eligibility requirements is in the state where she resides (option C). SCHIP is a federally funded program administered by individual states, and each state has its own eligibility criteria and application procedures. Reviewing the eligibility requirements on the state's official website or contacting the local SCHIP office will provide the most accurate and up-to-date information for your niece's specific situation.
5. If you own a company in a state where state funds aren't mandated for employee health insurance, one option for providing your employees with health care coverage for work-related injuries is self-insurance coverage (option D). Self-insurance allows companies to assume the financial risk of providing insurance benefits to employees without relying on traditional insurance carriers. This can offer more flexibility and cost control, but it requires extensive knowledge of insurance regulations, actuarial expertise, and sufficient financial resources to cover potential claims. It is important to consult with insurance and legal professionals for guidance on implementing self-insurance coverage properly. Option C, medical savings plans, typically refers to individual savings accounts for healthcare expenses and may not specifically address work-related injuries.