Instructions for the Project - Please read Project Details: There are 4 sections with 5 questions in each section. Each question is worth 2 points = 10 points per section Total of 40 points (10 per section) Make sure the answers are “in your own words” I know when students copy and paste from google and other websites. Read the question, do the research, and write it in your own words – if you do not follow these directions, be prepared to receive a ‘0’ for this section of the final exam. ( I will be sending all your papers through "turnitin" - which will identify if you have copied and pasted from other sites ) Best way to respond to these questions is to copy the entire 40 questions to another word document, once you have done with responding to answers copy and paste it back or attach as a word document. Please be mindful if I can't open the file you will receive a Zero grade also, therefore make sure you only attach it as a word document or PDF file. Section #1 - 1. List some of the advantages of managed care. 2. What are some of the ways that managed care organizations (MCOs) create an increased administrative burden on a physician's office? In other words, how does the increased guidelines they need to follow add more paperwork and processes to follow? 3. What are the differences between an individual and group insurance contract? 4. Why should a medical office specialist be familiar with terms used in managed care contracts? 5. What is meant by the No Balance Bill provision in a managed care contract? Section #2 - 1. Explain the Healthcare Cost and Utilization Project's rationale behind present on admission (POA) indicators. 2. Name the three major categories in which revenue codes are grouped. 3. Explain what the medical specialists should do if the insurance carrier paid twice for the same date of service and is requesting a refund. 4. List at least three reasons for contacting an insurance carrier to follow up on a claim. 5. What types of costs are included in a patient's out-of-pocket expenses? Section #3 - 1. Which three factors are considered in determining resource-based fee structures? 2. What types of listings can be found in the Medicine section of the CPT code book? 3. What is the purpose of cross-references in the CPT code book? 4. Explain what the initial preventive E/M codes are used to report. 5. What factors are considered in determining the level of medical decision making? Section # 4 - 1. What are the four components of a patient history? 2. Name at least two violations which the SynerMed corporation was charged with as a result of the findings revealed by a whistle-blower. 3. What elements should be part of a contingency plan designed to protect data in the event of a disaster or emergency? 4. Describe how protected health information (PHI) may be used by a coroner or medical examiner. 5. What are some of the specific services that may be available under Medi-Medi?