IIA IIA Certifications IIA-CFSA Questions & Answers

• Question 81:

  In utilization management, utilization reviews begin with a preadmission certification. In such situations, insureds must make notification within 48 hours of admission or face reduced or lost benefits. Utilization reviewers monitor the appropriateness of care while a patient is hospitalized. This is known as:

  A. Formal review

  B. UR primary activity

  C. Preadmission certification

  D. Concurrent review

  Correct Answer: D

• Question 82:

  When purchasing a flood insurance policy, there is a standard 30-day waiting period for new applications and endorsements for coverage. Exclusions of flood insurance are all EXCEPT:

  A. Boat houses (Buildings located)

  B. Structures entirely over water buildings (fences, retaining walls underground structures)

  C. Walkways, decks, driveways, patios

  D. None of these

  Correct Answer: D

• Question 83:

  Which of the following way best defines disability insurance?

  A. General-disability insurance:Provides benefits to a person who cannot perform any job that the person is qualified for because of sickness or injury. As long as the policyholder can still perform certain jobs that she is qualified for, she cannot recover

  B. Occupational-disability insurance:Provides benefits to a person who cannot perform his or her regular job because of sickness or injury

  C. Conditionally renewable policies:And your coverage can be cancelled in the event certain conditions stated in the policy aretriggered

  D. Only AandB

  Correct Answer: D

• Question 84:

  Major types of individual long-term disability policies are all EXCEPT:

  A. Non-cancelable policies

  B. Credit disability insurance

  C. Guaranteed renewable policies

  D. Conditional renewable policies

  Correct Answer: B

• Question 85:

  Typically, the costs associated with receiving care from the "in network" or approved providers are ______________ when care is rendered by non-contracting providers.

  A. More than

  B. Less than

  C. Same as

  D. Not comparable

  Correct Answer: B

• Question 86:

  A health services delivery organization that offers the option to its members to choose to receive a service from participating or a non-participating provider. Which one of the best suits to this definition?

  A. Point-of-service plan

  B. Health maintenance organization (HMO)

  C. Preferred provider organization (PPO)

  D. Independent practice Association (IPA) or organization (IPO)

  Correct Answer: A

• Question 87:

  A heath services delivery organization that offers the option its members choose to receive a service form participating or a non-participating provider which one of the following best suits to the definition?

  A. Point of service plan

  B. Health maintenance organization (HMO)

  C. Preferred provider organization (PPO)

  D. Independent practice Association (IPA) or organization (IPO)

  Correct Answer: A

• Question 88:

  Managed care has effectively formed a "go between," ________________ by existing as the gatekeeper between payers and providers and patients.

  A. PPO (Preferred provider organization)

  B. Full-service health insurance

  C. Brokerage or third party arrangement

  D. None of these

  Correct Answer: C

• Question 89:

  HMO (Health maintenance organization) must meet the specifications of the federal HMO act as well as meeting many rules and regulations required at state level. There are following basic models EXCEPT:

  A. Group model

  B. Individual practice association

  C. Network model

  D. None of these

  Correct Answer: D

• Question 90:

  Managed care health techniques are most often practical by organizations and professionals that assume risk for a/an:

  A. Infinite population

  B. Finite or defined population

  C. None of these

  D. Any one of these

  Correct Answer: B