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HSA 464 Test 2 Questions and Answers (100%
Correct Answers) Already Graded A+
The most common third-party payers in the United States healthcare
system are Ans: the government and insurance companies
Third-party payers are Ans: agents of patients that contract with
providers to pay patients medical bills
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Which organization offered prepaid medical care to school teachers?
Ans: Baylor University Hospital
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Under a direct service plan, the employer prepays ______ to take care of
its employees. Ans: specific hospitals and physicians
Under a commercial indemnity plan, the employer pays ______, which
reimburses ______. Ans: an insurance company; a hospital or physician of
the employees' choosing
Which three aspects of healthcare do managed care organizations
address? Ans: Quality, access, cost
______ plans allow members to seek care from a provider outside the
network for a higher premium, coinsurance rate, or deductible. Ans: POS
The Affordable Care Act of 2010 set out to Ans: -Provide insurance to the
32 million Americans still uninsured
-Require individuals to have health insurance
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-Reduce the rate of increase for Medicare and Medicaid spending
Most providers agree that ______ is the best way to be reimbursed. Ans:
charges
Which provisions reduced Disproportionate Share Hospital payments?
Ans: Bundled payment projects
Medicare Part ______ covers hospital services, whereas Medicare Part
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______ covers physician services. Ans: A; B
In 2010, Medicare was financed through which three primary sources?
Ans: General tax revenue, beneficiary premiums, payroll tax
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contributions
Resource-based relative value systems reimburse ______ for services
provided to Medicare beneficiaries. Ans: Physicians
Why are healthcare expenditures disproportionately higher for people
aged 65 or older? Ans: -This population utilizes a significant amount of
services
-Elderly people tend to have more chronic illnesses
-This population uses healthcare services at a much higher rate than the
population under age 65 does
The "donut hole," as created by Medicare Part D, refers to Ans: a gap in
coverage requiring all beneficiaries to pay out of pocket for all
prescriptions