Define and explain temporary disability claims. What is the role ...

[Chelseaamend]

Define and explain temporary disability claims. What is the role of the state in such claims? The medical biller? The claims examiner?
 
  What will be an ideal response?

Question 2

Which of the following is the OIG responsible for?
 
  a. Reviewing agency spending plans prepared by HHS management
  b. Outlining steps that HHS management should take to obtain meaningful audit coverage
  c. Conducting risk assessments of HMOs receiving funding, including non-Medicaid programs
  d. Assessing providers' capability to manage funds in accordance with federal regulations

[Li Jun]

Answer to Question 1

Answer:
Temporary disability claims are when the patient is not able to perform her job requirements until she recovers from the injury involved. When a physician sees a patient in this situation, a First Report is submitted and ongoing reports are issued every two to three weeks until the patient is discharged to return to work.
Each state has a waiting period before temporary disability becomes effective, usually three to seven days. During temporary disability, the employee is paid a portion of her salary as a tax-free benefit. Temporary disability ends when the patient is able to return to work, even with limitations or to a different department, or when the patient's condition ceases to improve and the patient is left with a permanent disability. Most healthcare plans do not have a disability benefit or death benefits. Therefore, the medical biller should check the health insurance before submitting such a claim. The health claims examiner should not receive a disability claim unless otherwise provided in the insurance plan. If one is received, it should be denied as not a covered benefit.

Answer to Question 2

B

[Chelseaamend]

TYSM

[Jossy]

Gracias!