Provider 1

Provider 1

Professional Development

18 Qs

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Provider 1

Provider 1

Assessment

Quiz

Professional Development

Professional Development

Practice Problem

Hard

Created by

Lee Ann Hardy

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18 questions

Show all answers

1.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

What is a deductible?

A provision by which the member is responsible for paying a minimal dollar amount at the time a service is rendered.

The amount of covered expenses for medical treatment that must be incurred and paid by the insured before benefits become payable by the insurer.

The maximum in benefit dollars paid by the insurer for certain services or conditions during the calendar or benefit year (may be a dollar amount, a number

of visits amount, or unlimited).

2.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

Health Insurance Privacy and Administration Act

Health Industry Privacy and Accountability Act

3.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

What is PHI?

Protected health information or PHI refers to individually identifiable health information transmitted or maintained in any form.

Provider health information or PHI refers to individually identifiable

provider information transmitted or maintained in any form or medium

by a HIPAA covered entity.

Protected health insurance or PHI refers to individually identifiable provider information transmitted or maintained in a specific form or medium by a HIPAA covered entity.

4.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

What is a co-pay?

The maximum in benefit dollars paid by the insurer for certain services or

conditions during the calendar or benefit year (may be a dollar amount, a number

of visits amount, or unlimited).

A provision by which the member is responsible for paying a minimal dollar

amount at the time a service is rendered.

The amount of covered expenses for medical treatment that must be incurred

and paid by the insured before benefits become payable by the insurer.

5.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

What type of Informational Alerts displays special handling messages for

litigation decisions, executive priority review or regulatory information?

CA DMHC

LERD

VIP Alerts

6.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

Which Composite tab can you view Open Service Requests?

Member

Interactions

Verification History

Messaging

Policy & Group

7.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

Which Composite tab would you access to view the Grandfathered

information on the member's policy?

Policy & Group

Verification History

Provider

Member

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