Chapter 20 2 Young People Can Remain Their Parents Insurance

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subject Authors Toni Hebda

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Question 16
Type: MCSA
Which type of billing codes is used by Medicare to determine the level of severity and per diem rate?
1. POA
2. MS-DRG
3. ICD
4. PPAC
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Question 17
Type: MCMA
The importance of billing codes and reimbursement for services cannot be overstated. Which of the following
responses are true regarding accurate code input and claims processing?
Standard Text: Select all that apply.
1. CPT codes were grouped into services by the first digit followed by four more digits that further described the
procedure.
2. The number 9 is reserved for visits related to evaluation and management procedures.
3. The CPT code 99211 is an office visit and used for injections.
4. Two digit modifiers are used to further distinguish services and procedures altering the billing process.
5. Inaccurate code input will delay claims processing.
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Question 18
Type: FIB
The __________________________ was developed by Medicare in an effort to control quality and cost and
minimize preventable complications.
Standard Text:
Question 19
Type: MCSA
Which of the following statements is true about the do-not-pay list?
1. If a patient develops a complication, Medicare will reimburse for all services.
2. If a patient develops complications, Medicaid will reimburse for all services.
3. If a patient has certain complications during the hospital stay, Medicare will not reimburse the hospital at the
higher rate for the treatment.
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4. If a patient develops a preventable complication, Medicare will demand the immediate transfer of the patient to
a different health care setting.
Question 20
Type: MCSA
What is the rationale the AMA is using to oppose the do-not-pay list?
1. Physicians assert each patient's circumstances are unique and complications cannot always be prevented or
explained.
2. The physicians assert this reimbursement ruling is unjust.
3. The physicians assert the do-not-pay list is punitive to health care providers.
4. The physicians assert do-not-pay list minimizes complications.
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Question 21
Type: MCSA
Which of the following statements is true about the projected results of the increase in federal and state mandated
health care cost reform legislation?
1. The increase in governmental regulations provides for a higher quality of care.
2. Governmental oversight is something that has been lacking in health care over the past several years.
3. The burden of proof is placed on the health care community.
4. The increase in governmental oversight allows for improved outcomes with decreased FTEs.
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Question 22
Type: MCSA
There has been an impact of the Health Insurance Reform Act, also known as The Patient Protection and
Affordable Care Act, on system use and design. Which of the following actions was enacted upon the president's
signature?
1. Young people can remain on their parents insurance until 24 years old.
2. Children with preexisting conditions are no longer covered.
3. New plans must offer free preventive care.
4. There are lifetime limits on benefits.
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Question 23
Type: MCMA
The effects of the new regulatory and reimbursement laws instigated subtle changes which will have an impact on
the physician office as well as outpatient facilities, ancillary services, and hospitals. In order to become, or
perhaps soon remain, a Medicare/Medicaid provider, a medical compliance program must be in place. According
to the Fox Group's website (n.d., p. 1) that includes which of the following measures?
Standard Text: Select all that apply.
1. Compliance with health and safety laws and regulations
2. Compliance with fraud complaints
3. Compliance with environmental laws and regulations
4. Compliance with human resources laws and regulations
5. Compliance with HIPAA laws and regulations
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Question 24
Type: MCSA
Implementing an electronic health record in a small primary care practice can be cost prohibitive. To assist in the
cost of the endeavor, the government has done which of the following?
1. Provided loans to physicians to purchase technology
2. Offered physicians stipends if they use the equipment correctly
3. Has given financial aid to larger practices to purchase equipment
4. Has given physicians the equipment to convert to electronic health records
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Learning Outcome:
Question 25
Type: MCSA
The impact of the mandated technology use has created change throughout the health care community. How has
the Affordable Health Care Act affected nursing?
1. Nursing professionals will spend more time at the computer and less time at the bedside.
2. There will be surge in applications for certified nursing assistant positions.
3. There will be a decreased need for point-of-care nurses.
4. There will be an increased need for nurse informatics specialists.
Question 26
Type: MCSA
The role of the informatics nurse is important to the success of the implementation of the EHR. Which of the
following statements is true about the expanded role of the informatics nurse?
1. The informatics nurse has the responsibility of maintaining the compliance procedures of the health care
setting.
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2. The informatics nurse has the responsibility of analyzing the coding system.
3. The informatics nurse has the responsibility to serve as the liaison between physician and patient and physician
and agency.
4. The informatics nurse has the responsibility of creating meaningful use policies.
Question 27
Type: MCMA
As technology is implemented in health care systems, the role of the nurse who has informatics experience and
education will be placed in leadership roles to do which of the following?
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Standard Text: Select all that apply.
1. Guide IT technicians
2. Work closely with physicians
3. Spearhead policy reform
4. Develop evidence based practice models
5. Participate in research initiatives
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Question 28
Type: MCSA
The Patient Protection and Affordable Care Act of March 2010 (PPACA) Section 1561 will, when fully activated
by 2014, extend affordable health care to an estimated 32 million more people. Which of the following is not a
financial impact of the Act?
1. A need for increased supplies
2. The need to hire more staff
3. The need to monitor patient outcomes
4. The need to hire additional health information technology (HIT) coordinators

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