Exam 2: Introduction to Health Insurance

Which is a type of single-payer system in which the government owns and operates health care facilities and providers (e.g., physicians) receive salaries?

The Financial Services Modernization Act (FSMA) (or Gramm-Leach-Bliley Act) prohibits sharing of medical information among health insurers and other financial institutions for use in making __________ decisions.

Amendments to the Dependents' Medical Care Act of 1956 created the Civilian Health and Medical Program-Uniformed Services (CHAMPUS), which was designed as a benefit for dependents of personnel serving in the armed forces as well as uniformed branches of the Public Health Service and the National Oceanic and Atmospheric Administration. The program is now called __________.

The Outpatient Prospective Payment System (OPPS), which uses __________ to calculate reimbursement, is implemented for billing of hospital-based Medicare outpatient claims.

Which act allows employees to continue health care coverage beyond the benefit termination date?

Medicare requires providers to submit the __________ claim for payment of outpatient and office services.

The National Correct Coding Initiative (NCCI) was created to promote national correct coding methodologies and to eliminate __________ coding.

Clinical Laboratory Improvement Act (CLIA) legislation established __________ for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed.

Prior to implementation of a prospective payment system for acute care hospital inpatient stays, reimbursement was generated on a __________ basis, which issued payment based on daily rates.

Which may specifically result in the early detection of health problems, allowing less drastic and less expensive treatment options?

Which is a centralized health care system adopted by some Western nations (e.g., Canada, Great Britain) and funded by taxes?

Which act provided federal grants for modernizing hospitals that had become obsolete because of a lack of capital investment during the Great Depression and World War II (1929 to 1945)?

The Patient Protection and Affordable Care Act (PPACA) was signed into federal law on March 23, 2010, and resulted in the creation of a Health Insurance Marketplace to:

The Medicare Contracting Reform initiative (MCR) was established to integrate the administration of Medicare Parts A and B fee-for-service benefits with new entities called __________.

Which type of health insurance coverage is subsidized by employers and other organizations?

Which has a more narrow focus because it is the patient record created for a single medical practice using a computer, keyboard, mouse, optical pen device, voice recognition system, scanner, and/or touch screen?

The Resource-Based Relative Value Scale (RBRVS) system reimburses physicians' practice expenses using a __________.

The Veterans Healthcare Expansion Act of 1973 authorized Veterans Affairs to establish __________ to provide health care benefits for dependents of veterans rated as 100 percent permanently and totally disabled as a result of service-connected conditions, veterans who died as a result of service-connected conditions, and veterans who died on duty with less than 30 days of active service.

The American Recovery and Reinvestment Act of 2009 (ARRA) established electronic health record (EHR) __________ during three stages to achieve the goal of improved patient care outcomes and delivery as well as data capture and sharing, advance clinical processes, and improved outcomes.

One result of the Patient Protection and Affordable Care Act (PPACA) was establishment of state health insurance __________ that Americans will use to purchase health coverage that fits their budget and meets their needs.