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July 29, 2015

Homework Help: reimbursement methodologies

Posted by Anonymous on Tuesday, May 11, 2010 at 8:56pm.

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.

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