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MULTIPLE CHOICE. Choose the one alternative that best completes the statement

Question : MULTIPLE CHOICE. Choose the one alternative that best completes the statement : 2139099

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

11) Unbundling is:

A) services that never happened.

B) a procedure where one service is divided into many services and billed accordingly.

C) services designated so that maximum fees can be charged.

D) hospital room charges that are reasonable but other charges are very high.

12) Bounty hunters in the medical fraud area are:

A) people who use strong-arm tactics to collect bills that are not owed.

B) people who collect a fee for patient referral.

C) facilities that specialize in the patients who are most seriously ill.

D) doctors who receive a fee for a particular diagnosis.

13) What Houston school personnel have been offered rewards to refer troubled students?

A) Teachers B) Counselors

C) Nurses D) Assistant principals

14) The term "self-referral" stands for the practice of:

A) HMO selection of specialists and services based on providers in a network.

B) doctor selection of specialists and services based on financial connections.

C) insurance company selection of specialists and services based on low cost.

D) patient selection of specialists and services based on recommendations from friends.

15) Doctors referring patients to labs and other institutions in which they have partial ownership is problematic for all of the following reasons except:

A) higher prices.

B) conflict of interests.

C) failure to make a referral if it is no benefit to doctor.

D) unnecessary referrals.

16) American dialysis patients are how many times more likely to die in a given year as those in Western Europe or Japan?

A) 2 B) 3 C) 5 D) 4

17) Prominent universities and institutions have also been involved in Medicare/Medicaid fraud and abuse. Their activities include all of the following except:

A) $10 million in false Medicare claims.

B) charging $18 separately for blood tests; private insurers paid 65 cents.

C) unnecessary lab tests.

D) not following guidelines and underpricing services.

18) Excessive billing can take several forms. What are retainers?

A) Contracts for services that exceed Medicare limits

B) Patients giving up the right to question fees

C) Up-front fees for services covered by Medicare supplemental policies

D) Patients paying directly for services such as calls, refills, and conferences that Medicare considers covered

19) Excessive billing can take several forms. What are waivers?

A) Patients giving up the right to question fees

B) Up-front fees for services covered by Medicare supplemental policies

C) Patients paying directly for services such as calls, refills, and conferences that Medicare considers covered

D) Contracts for services that exceed Medicare limits

20) Health Maintenance Organizations (HMOs) are the new model for providing medical care. Criticisms of HMOs include all of the following except:

A) negligent under-treatment. B) multiple trips to many specialists.

C) overemphasis on profit instead of care. D) big salaries for administrators.

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