The term that describes requirements created by accreditation organizations is
standards
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15
Currently, more than 70____ Americans are enrolled in some type of managed care program in response to regulatory initiatives affecting health care cost and quality
million
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15
A series of fixed-length records submitted to payers to bill for health care services is an electronic
flat file format
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15
A clearinghouse that coordinates with other entities to provide additional services during the processing of claims is a
value-added network
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15
Which means that the patient and/or insured has authorized the payer to reimburse the provider directly?
assignment of benefits
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heart
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lifesaver
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15
Which is considered a covered entity?
private-sector payers that process electronic claims
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shark
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15
Which is an interpretation of the birthday rule regarding two group health insurance policies when the parents of a child covered on both policies are married to each other and live in the same household?
the parent whose birth month and day occurs earlier in the calendar year is the primary policyholder
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15
Which would likely be subject to a managed care plan quality review?
results of patient satisfaction surveys
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15
Charged for services procedures, patient personal payments, and third-party payments are entered in the computerized
patient account record
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15
Which define employer contributions and ask employees to be more responsible for health care decisions and cost sharing?
consumer directed health plans
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15
Which requires providers to make certain written disclosures concerning all finance charges and related aspects of credit transactions?