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International College of Health Sciences *
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MISC
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Accounting
Date
Nov 24, 2024
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A is a correspondence sent from the insurance payer to the patient after they receive healthcare services to explain the status of their claim. Correct Answer: Explanation of Benefits Which one of the following is NOT a data entry denial? Correct Answer: Coverage Terminated What does being a "participating provider" agrees to when signing a contract with an insurance payer? Correct Answer: The provider wishes to participate with and agree to accept the fee schedules set by that specific insurance. Which of the following type of insurance that allows members to choose medical services as needed and can go in or out of network. Correct Answer: POS Which of the following is an account that is usually funded by the employee only and reimburses employee for specified expenses as they are incurred? Correct Answer: FSA What role does an Insurance Provider Representative play? Correct Answer: Is the liaison between the insurance payer and the provider. The provider, hospital, or other entity that agrees to provide healthcare services to an insurance plan's enrollees is a: Correct Answer: Participating provider Downloaded by Peace Ogwuche (peaceogwuchel23@ gmail.com)
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Related Questions
Which of the following is not an insurance management tool?
Group of answer choices
deductibles.
screening of applicants.
limits on insurance.
restrictive covenants.
signalling.
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Which of the following types of insurance does NOT involve a contract with an external party?
a. self insurance
b. directors and officers insurance
c. property insurance
d. life insurance
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The benefit of the policy must offer inflation protection.
The contract must offer to cover pre-existing conditions.
The contract must be guaranteed renewable.
The contract must offer to pay a nonforfeiture benefit.
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Which is Idemenity Plan and which is Managed Care Plan?
Insureds create contract with an insurer who does not provide health care services
The higher the deductible, the lower the premium
Insured receive health care services from a designated group of providers
May not even involve an insurance company
No annual deduction is incurred, but a small co-payment may be required
I most value the freedom of choice and am willing to pay for it.
Cost is my most important consideration.
I’d rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider.
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Which of the following statements regarding the Patient Protection and Affordable Care Act (ACA) is true?
Group of answer choices
a. The ACA eliminates lifetime limits on total health care insurance payments by insurers.
b. The ACA limits the total number of surgeries for the insurers.
c. The ACA requires employers to reimburse the cost of hospital stays of the insured.
d. The ACA decides the insurance payments for dependents.
e. The ACA provides major medical insurance with low deductibles to protect against catastrophic illnesses.
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Briefly explain the following characteristics of long-term care insurance.
Type of long-term care policies
Triggers to become eligible for benefits
Exclusions
Protection against inflation
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Which type of insurance is not deductible as self-employed health insurance? a. Long-term care insurance O b. Medical insurance Oc. Disability insurance Od. Dental insurance Oe. Spousal medical insurance
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Which of Ike following statements is CORRECT about he Missialement of Age provision in a health policy?
A.Il is not an oplional provision.
B.It allows an insurance company to adjust the levels of policy benefits for an insured who misslated his age.
C.It limits the time wilhin which an insurance company may conlest a claim on the basis of misstatement of age.
D.It always voids the contract
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With respect to employer-sponsored health insurance plans, the amount of money a covered participant must pay before health insurance benefits become active is known as which of the following?
Select one:
a.
Premium
b.
Safe harbor
c.
Deductible
d.
Coinsurance
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Entity A obtains life insurance for its key employee from Entity B (an insurance company). Entity B cedes the insurance contract with Entity A to Entity C, another insurance company. How should Entity B account for the insurance contract with Entity C?A. using the modified version of the general model applicable for onerous insurance contractsB. using the general modelC. using a modified version of (a) or (b) applicable to reinsurance contracts heldD. using the premium allocation approach
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A "waiver-of-premium” clause:
Select one:
a. allows the person to purchase additional insurance at no extra cost
means the insured will receive the cash value immediately
allows an insurance agent to pay your premiums
b.
C.
O d. waives the suicide clause
e. pays premiums in the event of illness or disability
Clear my choice
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The Insuring clause in an Accident & Health policy states which of the following information?
A. The insured's obligations
B. The insurance company's obligations
C. The risks excluded from coverage
D. The cost of the coverage
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What does the insurer agree to pay for in addition to covering losses in an insurance policy?
Services such as investigating claims and defending the insured
The entire policy limit
Premium costs for the policy period
Only losses below the deductible
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What is a contractual adjustment? How does a health care organization account for a contractual adjustment?
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Which of the following would not be an appropriate subaccount for an Insurance Expense Account?
Multiple Choice
Auto Insurance Expense.
Liability Insurance Expense.
Rent Expense.
Renter Insurance Expense.
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What type of private insurance increases the subscriber’s choice of provider and improves access to services financially or through an increased approved network of providers?
A. Exclusive
B. Substitutive
C. Supplementary
D. Complementary
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Insurance companies may use all of he following sources to oblain underwriting information about an applicant EXCEPT.
A.The Medical Information Bureau (MIB)
B.Inspection report companies
C.Actuarial raling bureaus
D.A Fair Credit report
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How does the Health Insurance Portability and Accountability Act (HIPAA) facilitate electronic transactions?
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What kind of insurance forms may not be included in the comprehensive forms?
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Choose the best answer.
1.Which statement is TRUE about an insurance contract? *
a.The insurer is the party that has an obligation under an insurance contract to compensate a policyholder if an insured event occurs.
b.The policyholder is the party that has a right to compensation under an insurance contract if an insured event occurs.
c.The insured event is an uncertain future event that is covered by an insurance contract and creates insurance risk.
d.All of these statements are true about an insurance contract.
2. IFRS 17 provides that insurance contracts should *
a.Comply with all existing IFRS
b.Generally continue to be subject to existing accounting policies.
c.Comply with the IFRS Framework document.
d.Be covered by IAS 32 and IFRS 9
3.An insurance contract can contain both deposit and insurance elements. An example might be a reinsurance contract where the cedant receives a repayment of the premiums at a future date if there are no claims under the contract. Effectively this…
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- Which of the following is not an insurance management tool? Group of answer choices deductibles. screening of applicants. limits on insurance. restrictive covenants. signalling.arrow_forwardWhich of the following types of insurance does NOT involve a contract with an external party? a. self insurance b. directors and officers insurance c. property insurance d. life insurancearrow_forwardWhich of the following is not a requirement of a "qualified" long-term care insurance policy? The benefit of the policy must offer inflation protection. The contract must offer to cover pre-existing conditions. The contract must be guaranteed renewable. The contract must offer to pay a nonforfeiture benefit.arrow_forward
- Which is Idemenity Plan and which is Managed Care Plan? Insureds create contract with an insurer who does not provide health care services The higher the deductible, the lower the premium Insured receive health care services from a designated group of providers May not even involve an insurance company No annual deduction is incurred, but a small co-payment may be required I most value the freedom of choice and am willing to pay for it. Cost is my most important consideration. I’d rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider.arrow_forwardWhich of the following statements regarding the Patient Protection and Affordable Care Act (ACA) is true? Group of answer choices a. The ACA eliminates lifetime limits on total health care insurance payments by insurers. b. The ACA limits the total number of surgeries for the insurers. c. The ACA requires employers to reimburse the cost of hospital stays of the insured. d. The ACA decides the insurance payments for dependents. e. The ACA provides major medical insurance with low deductibles to protect against catastrophic illnesses.arrow_forwardBriefly explain the following characteristics of long-term care insurance. Type of long-term care policies Triggers to become eligible for benefits Exclusions Protection against inflationarrow_forward
- Which type of insurance is not deductible as self-employed health insurance? a. Long-term care insurance O b. Medical insurance Oc. Disability insurance Od. Dental insurance Oe. Spousal medical insurancearrow_forwardWhich of Ike following statements is CORRECT about he Missialement of Age provision in a health policy? A.Il is not an oplional provision. B.It allows an insurance company to adjust the levels of policy benefits for an insured who misslated his age. C.It limits the time wilhin which an insurance company may conlest a claim on the basis of misstatement of age. D.It always voids the contractarrow_forwardWith respect to employer-sponsored health insurance plans, the amount of money a covered participant must pay before health insurance benefits become active is known as which of the following? Select one: a. Premium b. Safe harbor c. Deductible d. Coinsurancearrow_forward
- Entity A obtains life insurance for its key employee from Entity B (an insurance company). Entity B cedes the insurance contract with Entity A to Entity C, another insurance company. How should Entity B account for the insurance contract with Entity C?A. using the modified version of the general model applicable for onerous insurance contractsB. using the general modelC. using a modified version of (a) or (b) applicable to reinsurance contracts heldD. using the premium allocation approacharrow_forwardA "waiver-of-premium” clause: Select one: a. allows the person to purchase additional insurance at no extra cost means the insured will receive the cash value immediately allows an insurance agent to pay your premiums b. C. O d. waives the suicide clause e. pays premiums in the event of illness or disability Clear my choicearrow_forwardThe Insuring clause in an Accident & Health policy states which of the following information? A. The insured's obligations B. The insurance company's obligations C. The risks excluded from coverage D. The cost of the coveragearrow_forward
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