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Module 10 Checkpoint Answers
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A. Group representative |
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Where to Get Help: |
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1.) A member receives an insurance card on which his last name is spelled incorrectly. |
B |
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2.) A 12 year old boy needs a camp physical. His parents don't know if the physical is covered by their HMO plan. |
D or B |
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3.) The 22 year old son of an HMO subscriber is a full time college student. The plan provides coverage for students until age 23 with proof of student status. The family receives notification that his membership has been terminated even though he is still a full time student. |
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4.) A patient receives a bill from his physician's office indicating that a claim was sent to his old insurance plan. The claim was denied and now the doctor is seeking payment from the patient. |
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5.) A group enrolls new members for January 1. The completed forms are sent to the plan by December 15. By January 10, members of the group still have not received their membership identification cards and several members have physician appointments in the next week. |
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