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Aug 17th, 2012 Comments: 1

Healthcare Business Analyst Interview Questions

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Here we are listing few very important interview questions for recruiting health care business analyst / testers.

1. What is the difference between Medicare & Medicaid?

Medicare is a USA govt health insurance program which will be offered to those who are above 65 years of old. Where as Medicaid is also a USA govt health insurance program which will be offered to low income people.

2. What is the age limit for a member to be eligible for medicare?

Right now the age limit is 65 years and some discussions are going on to decrease the age limit.

3. What are the facilities a provider must have in order to participate in medicare program?

The providers or Hospitals need to pass certain parameters in order to be eligible to participate in medicare program. They should be in a position to provide certain healthcare services that are listed by govt. More information click here.

 Typical Health insurance business analyst interview questions

4. What is EDI & HIPAA ? how they are used in healthcare industry?

EDI is: Electronic data interchange and HIPAA is health insurance portability and accountability. HIPAA is a set of protocols or rules set for the privacy of the individuals.

EDI is used to transfer the medical related data in the form of Electronic data transfer.

5. What is COB? explain little about it.

COB is coordination of benefits and is used mainly when an individual has two insurance policies and in this case how to adjudicate the claim? the whole process is to pay the exact amount which is required.

6. What is EOB? explain little about it.

EOB is explanation of benefits which is a detailed explanation given by insurance company to its policy holder regarding a claim.

7. What is a claim in healthcare industry and how the claim process works electronically?

8. What is the difference between Hospital claim, Medical claim and Member claim?

9. What do you need to enroll a new member / subscriber?

10. What is a Medical plan?

Please answer the above questions in the comments section below.

Comments

( 1 )
  1. Satyabrata Pal Aug 23rd, 2012 22:19

    Medicare is the federal government program established under Title XVIII of the Social
    Security Act of 1965 to provide hospital, medical and other covered benefits to elderly
    and disabled persons. Medicare is available for
    • Persons age 65 or older
    • Persons with qualifying disabilities (regardless of age)
    • Persons with end-stage renal disease (ESRD)
    Medicaid
    Title XIX of the Social Security Act of 1965 established Medicaid, a joint federal and
    state program that provides hospital expense and medical expense coverage to the lowincome
    population and certain aged and disabled individuals.

    Medicaid will be govern by the state government,where as Medicare will be govern by Federal government.

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