for DR.SAMUELSON ONLY!!!!!

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week3-quiz-smhs.docx

Week#3-Quiz-SMHS

1. Which of the following is not considered a “life event”?

A.

Loss of employment

B.

Marriage or divorce

C.

Birth or adoption of a child

D.

Changing employment

2. Beginning in 2014, which of the following organizations will be able to enroll individuals into a health plan?

A.

The Office of Personnel Management

B.

State insurance departments

C.

State health insurance exchanges

D.

Medicare agencies

3. The four primary claims core competencies are:________, ____, _____, _______.

4. Today’s transactional processing systems auto adjudicate on average what percentage of claims that are accepted into the processing system.

A.

100%

B.

82%

C.

70%

D.

75%

5. Member services and membership services are synonymous terms.T/F?

6. List the seven elements of compliance,___,___,___,___,___,___ and describe why they are important to fraud control,____.