The corporate headquarters of United Health Group are located where?
Minneapolis, Minnesota
100
Who provides medicare?
Federal Goverment
100
Name four types of insurance?
Dental,visions,medical,and Disability
100
What is the differnce between a non participating provide and a participating provider?
Non participating has chosen not to enter a contractural agreement and a participating provider has a contractual arrangement with us
100
What is FFS?
Fee for service
200
Define UHG core value performance?
I am commited to delivering and demonstarting excellence in everything I do
200
Name two characteristics of medicare?
It provides medical benefits based on income eligibility,available to people with end - stage renal disease, state administered program, over 65
200
What are the parts of insurance?
Co insurance, co pay, deductible and premium
200
What are some of the different names for participating provider?
Par,contracted,in network,INN, and participating
200
What is PHI?
Protected health information
300
Name the three businesses that make up Optum?
OptumHealth,OptumInsight,OptumRx
300
T/F.Services that are covered under both medicare and medicaid will be paid first by medicaid.
False
300
What is the difference between group and individual insurance?
Individual is personal policy design to protect the individual and the dependents oppose group which is design to protect a specific group of people under a single insurance contract.
300
T/F.Can a non participating provider balance bill?
True
300
What is OOP and COB?
Out of pocket and coordination of benefits
400
Name three of the six principles of new basic?
Quality and Accuracy,timeliness,compliance,value and affordaility,transperency,simplicity
400
What is dual eligibilty?
Medicare who have a limited income may receive help paying for out of pocket medical insurance through medicaid
400
What are the two main advantages of group insurance?
Lower cost and Waived insurability
400
What are three provider Identification numbers?
National provider Identification(NPI), Social Security Number(SSN), federal tax identification number (TIN)
400
Name two things about CAP?
Is a lump sum payment issued once a month instead of per claim and payment is based on the number of individuals the provider usually sees in a month
500
What is the mission statement of United health group?
Help everyone live heathlier lives and to help make the health system work better for everyone.
500
Y/N. My neighbor who requires home health care is covered under medicaid and is having a brain tumor removed in December and medicaid does not cover all the medical costs. Can she sign up for medicare to cover the remaining medical fees?
Yes
500
Y/N My employer emailed me link to sign up for my benefits for the upcoming year after reviewing the different plans I signed up for a PPO plan for my faimly. They also provided me a HSA account which my grandmother who is a dependent use to buy my child a nubulizer? Could we be penalized?
Yes or no
500
What balance bill?
Member do not get bill for the difference between their billed charges and the contracted amount for their service
500
What is the differnce between FFS and CAP
FFS reimbursed the PCP per claim and CAP reimbursed the PCP once a monh