Under the Newborns’ and Mothers’ Health Protection Act, health plans and health insurers may not restrict covered hospital benefits for a mother and her newborn to less than (a)_____ hours following a vaginal delivery or (b) ______hours following a cesarean delivery? a. (a) 48 hours, (b) 96 hours b. (a) 24 hours, (b) 72 hours c. (a) 48 hours, (b) 72 hours d. (a) 36 hours, (b) 96 hours
Under the Newborns’ and Mothers’ Health Protection Act, health plans and health insurers may not restrict covered hospital benefits for a mother and her newborn to less than (a)_____ hours following a vaginal delivery or (b) ______hours following a cesarean delivery? a. (a) 48 hours, (b) 96 hours b. (a) 24 hours, (b) 72 hours c. (a) 48 hours, (b) 72 hours d. (a) 36 hours, (b) 96 hours
Practical Management Science
6th Edition
ISBN:9781337406659
Author:WINSTON, Wayne L.
Publisher:WINSTON, Wayne L.
Chapter2: Introduction To Spreadsheet Modeling
Section: Chapter Questions
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Question
Under the Newborns’ and Mothers’ Health Protection Act, health plans and health insurers may not restrict covered hospital benefits for a mother and her newborn to less than (a)_____ hours following a vaginal delivery or (b) ______hours following a cesarean delivery?
a. (a) 48 hours, (b) 96 hours
b. (a) 24 hours, (b) 72 hours
c. (a) 48 hours, (b) 72 hours
d. (a) 36 hours, (b) 96 hours
Group of answer choices
a
b
c
d
Flag question: Question 18
Question 18
1 pts
CMS, CDC, and the FDA have oversight responsibility for various elements of The Clinical laboratory Improvement Amendments (CLIA).
True or False?
Group of answer choices
True
False
Flag question: Question 19
Question 19
1 pts
What HHS organization has primary oversight responsibility for human subject research related insurance programs and activities?
a. Institutional Review Board
b. Organ Procurement Transplant Network
c. Patient Self-Determination Act
d. Office for Human Research Protection
Group of answer choices
d
a
b
c
Flag question: Question 20
Question 20
1 pts
What compilation of fire safety requirements is the dominant component of The Joint Commission’s “environment of care” standards?
a. Basic Building Information
b. Statement of Conditions
c. Life Safety Codes
d. Plans for Improvement Risk
Group of answer choices
c
a
b
d
Flag question: Question 21
Question 21
1 pts
Which of the following are considered essential claim management functions?
a. Claim Reporting
b. Claim Investigation
c. Reserve Setting
d. Liability Determination
Group of answer choices
all of the above
a, b, c
a and b
b
Flag question: Question 22
Question 22
1 pts
Which of the following are considered alternative dispute resolution mechanisms?
a. Arbitration
b. Mediation
c. Summary Judgment
d. Trial by Jury
Group of answer choices
a and b
a, b, c
b
all of the above
Flag question: Question 23
Question 23
1 pts
Which of the following categories of materials should be maintained in a claim file?
a. Correspondence
b. Transcripts of Recorded Interviews
c. Medical Records
d. The hospital’s Medicare Cost Reports
Group of answer choices
a, b, c
a and b
b
all of the above
Flag question: Question 24
Question 24
1 pts
Which of the following organizations require reports when money has been paid on behalf of a practitioner to settle a legal claim asserted against the practitioner?
a. The Legal Aid Society
b. National Practitioner Data Bank
c. Consumer Reports
d. National Patient Safety Foundation
Group of answer choices
b
a
c
d
Flag question: Question 25
Question 25
1 pts
The following are factors used to determine whether risk should be retained or transferred:
a. Size and type of organization and its operations
b. Organization’s risk-taking philosophy
c. Financial strength and resources
d.Effectiveness of risk management program
e. Cost efficiencies and cost certainty
Group of answer choices
all of the above
a, b, c, d
b, c, d, e
a, c, d, e
Flag question: Question 26
Question 26
1 pts
All of the following statements about a Self-Insurance Trust are true EXCEPT for:
a. Bank account administered by a trustee
b. Easiest and simplest risk funding vehicle
c. Is not insurance
d. Flexible in that it can write both profit and non-profit risks
e. Limited purpose
Group of answer choices
d
a
b
c
d
Flag question: Question 27
Question 27
1 pts
Retain the small predictable layers of risk and transfer the unpredictable catastrophic layer of risk. Does this statement promote appropriate risk financing decision making?
True or False
Group of answer choices
True
False
Flag question: Question 28
Question 28
1 pts
The two types of risk transfer are:
a. Insurance and non-insurance contractual transfer
b. Risk Retention and Risk Transfer
c. Borrowing and Indemnification
d. Insurance and Avoidance
Group of answer choices
a
b
c
d
Flag question: Question 29
Question 29
1 pts
Which of the following statements are true about a captive insurance company?
a. Highly formalized form of self-insurance
b. Closely held insurance company
c. Flexible in writing multiple lines of coverage
d. Easiest and least costly to implement and manage
e. Elevates the risk management function within the organization
Group of answer choices
a, b, c, e
a, b, c, d
b, c, d, e
a, b, d, e
Flag question: Question 30
Question 30
1 pts
What does “IBNR” stand for?
a. Incurred But Not Reported
b. Incident But Not Related
c. Incurred But Not Released
d. Incident By Not Responding
Group of answer choices
a
b
c
d
Flag question: Question 31
Question 31
1 pts
Medical Professional Liability, Commercial General Liability and Automobile liability are three common “Third-party liability” coverages for
healthcare providers.
True or False?
Group of answer choices
True
False
Flag question: Question 32
Question 32
1 pts
Commercial General Liability covers injuries to Third Parties on the premises as the result of negligence in connection with the medical aspects of its premises.
True or False?
Group of answer choices
True
False
Flag question: Question 33
Question 33
1 pts
If a voluntary attending physician who carries their own medical professional liability coverage is named in a claim with the hospital, and if the hospital and physician are found to be negligent, the hospital may be held financially liable for the inadequacy of the physician’s limits under the theory of joint and several liabilities.
True or False?
Group of answer choices
True
False
Flag question: Question 34
Question 34
1 pts
A medical professional liability policy responds to bodily injury allegations as the result of the delivery or failure to deliver medical services. However, it may not respond to allegations for “wrongful acts” in the administration of a managed care plan.
True or False?
Group of answer choices
True
False
Flag question: Question 35
Question 35
1 pts
Excess Liability (Umbrella excess liability) coverage is a comprehensive form of excess liability coverage, providing coverage excess of a number of third party exposures such as medical professional liability, commercial general liability, automobile liability, non-owned aircraft liability, time element coverage and employer’s liability.
True or False?
Group of answer choices
True
False
Flag question: Question 36
Question 36
1 pts
Automobile liability coverage protects against loss arising out of the ownership, maintenance, or use of automobiles and their equipment. It extends to vehicles “you own, hire or borrow, and those you do not own but may be responsible for, “such as the personal car of an employee used in a home health operation.
True or False?
Group of answer choices
True
False
Flag question: Question 37
Question 37
1 pts
Hospitals need to purchase separate heliport liability coverage for their landing sites for life-flight operators or other emergency helicopter landings.
True or False?
Group of answer choices
True
False
Flag question: Question 38
Question 38
1 pts
The purpose of D&O insurance is to protect directors, trustees and key executives in the event of personal liability litigation, or to insure the healthcare entity itself from its obligation to provide indemnity from such litigation.
True or False?
Group of answer choices
True
False
Flag question: Question 39
Question 39
1 pts
Worker’s Compensation insurance provides statutory benefit coverage but limits medical benefits to what the employer’s medical insurance plan would cover?
True or False?
Group of answer choices
True
False
Flag question: Question 40
Question 40
1 pts
What organization called for the establishment of “rules of the road” for distributing health care data?
a. Office of the National Coordinator for Health Information Technology (ONC)
b. Department of Defense (DOD)
c. Health and Human Services (HHS)
d. Institute of Medicine (IOM)
Group of answer choices
d
a
b
c
Flag question: Question 41
Question 41
1 pts
The risk management professional needs tools to:
a. Automate common processes
b. Knowledge bank of credible information on which sound risk reduction strategies can be based
c. Access complete financial information of the organization
d. Gather intelligence for in-depth analysis in real-time
Group of answer choices
a, b, d
a, b, c
b, c, d
a, c, d
Flag question: Question 42
Question 42
1 pts
Records created and maintained by a patient regarding their health are called?
a. Electronic Heath Records
b. Medical Records
c. Standardize data set
d. Legal Health Record
e. Personal Health Record
Group of answer choices
e
a
b
c
d
Flag question: Question 43
Question 43
1 pts
The use of computerized clinical applications in health care can include:
a. Automated Dispensing Systems
b. Patient tracking Systems
c. Bed Tracking Systems
d. Drug Interaction Programs
e. Medical Device Tracking Systems
Group of answer choices
all of the above
a, b, c, d
b, c, d, e
a, c, d, e
Flag question: Question 44
Question 44
1 pts
To encourage the implementation of EHRs among physician who participate in the Medicare program, CMS announced in 2005 that it would offer physicians free of charge an EHR software program.
True or False?
Group of answer choices
True
False
Flag question: Question 45
Question 45
1 pts
Because of its unique characteristics, e-mail communication between health care providers and patients raises risk management, legal, and regulatory concerns about cost, confidentiality, privacy, medical record documentation and ease of use.
True or False?
Group of answer choices
True
False
What color pants does Jake from State Farm where?
a. Navy
b. Black pin stripe like in Good Fellas
c. Chartreuse
d. Khaki
Group of answer choices
d
c
a
b
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