Health Insurance A Guide to Billing

Solutions Manual for Understanding Health Insurance A Guide to Billing and Reimbursement (2025 Edition) 20 th Edition By Michelle Green (All Chapters 1-16, 100% Original Verified, A+ Grade)

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Solution and Answer Guide: Michelle A. Green, Understanding Health Insurance: A Guide to Billing and Reimbursement: 2025, 20th Edition, 9798214112978; Chapter 16: Workers’ Compensation Solution and Answer Guide

MICHELLE A. GREEN, UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND

REIMBURSEMENT: 2025, 20

TH

EDITION, 9798214112978; CHAPTER 16: WORKERS’ COMPENSATION

TABLE OF CONTENTS

Review...........................................................................................................................1 Multiple Choice.......................................................................................................................................1

REVIEW

MULTIPLE CHOICE

1.The Office of Workers’ Compensation Programs (OWCP) administers disability compensation programs that provide a.life insurance.b.on-the-job training.c.Social Security benefits.d.vocational rehabilitation.

ANS: d

Analysis:

a.Incorrect. Life insurance is incorrect. The Office of Workers’ Compensation Programs (OWCP) administers disability compensation programs that provide vocational rehabilitation, along with medical treatment and wage replacement benefits.b.Incorrect. On-the-job training is incorrect. The Office of Workers’ Compensation Programs (OWCP) administers disability compensation programs that provide vocational rehabilitation, along with medical treatment and wage replacement benefits.c.Incorrect. Social security benefits is incorrect. The Office of Workers’ Compensation Programs (OWCP) administers disability compensation programs that provide vocational rehabilitation, along with medical treatment and wage replacement benefits.d.Correct. The Office of Workers’ Compensation Programs (OWCP) administers disability compensation programs that provide vocational rehabilitation, along with medical treatment and wage replacement benefits.

2.Which department in the Division of Federal Employees’ Compensation (DFEC) adjudicates new claims for Federal Employees’ Compensation Act program benefits?a.Administrative Review Board b.FECA Claims Administration c.Occupational Safety and Health Administration d.Office of Workers’ Compensation Programs

ANS: d

Analysis:

a.Incorrect. The federal Department of Labor Administrative Review Board issues agency decisions in cases arising from worker protection laws, including whistleblower and public contract laws.© 2025 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 

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Solution and Answer Guide: Michelle A. Green, Understanding Health Insurance: A Guide to Billing and Reimbursement: 2025, 20th Edition, 9798214112978; Chapter 16: Workers’ Compensation The department in the Division of Federal Employees’ Compensation (DFEC) that adjudicates new claims for Federal Employees’ Compensation Act program benefits is the Office of Workers’ Compensation Programs (OWCP).b.Incorrect. The FECA Claims Administration adjudicates new claims for benefits, manages ongoing cases, pays medical expenses and compensation benefits to injured workers and survivors, and helps injured employees return to work when they are medically able to do so. The department in the Division of Federal Employees’ Compensation (DFEC) that adjudicates new claims for Federal Employees’ Compensation Act program benefits is the Office of Workers’ Compensation Programs (OWCP).The department in the Division of Federal Employees’ Compensation (DFEC) that adjudicates new claims for Federal Employees’ Compensation Act program benefits is the Office of Workers’ Compensation Programs (OWCP).c.Incorrect. The Occupational Safety and Health Administration ensures safe and healthful working conditions for workers. The department in the Division of Federal Employees’ Compensation (DFEC) that adjudicates new claims for Federal Employees’ Compensation Act program benefits is the Office of Workers’ Compensation Programs (OWCP).d.Correct. The department in the Division of Federal Employees’ Compensation (DFEC) that adjudicates new claims for Federal Employees’ Compensation Act program benefits is the Office of Workers’ Compensation Programs (OWCP).

3.Which is the federal Department of Labor agency that is mandated to work cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States?a.Coal Mine Workers’ Compensation Program b.Federal Employment Liability Act c.Mine Safety and Health Administration d.Occupational Safety and Health Administration

ANS: c

Analysis:

a.Incorrect. The Coal Mine Workers’ Compensation Program provides compensation and medical coverage to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment. The Mine Safety and Health Administration is mandated to work cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States.b.Incorrect. The Federal Employment Liability Act is legislation, signed into law by President Roosevelt in 1908, that provides railroad employees with protection from employer negligence and makes railroads engaged in interstate commerce liable for injuries to employees if the railroad was negligent. The Mine Safety and Health Administration is mandated to work cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States.c.Correct. The Mine Safety and Health Administration is mandated to work cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States.d.Incorrect. The Occupational Safety and Health Administration ensures safe and healthful working conditions for workers, and its goals are to establish and enforce standards and to provide training, outreach, education, and assistance. The Mine Safety and Health Administration is mandated to work cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States.

4.Which adjudicates new claims for Federal Employees’ Compensation Act program benefits?a.Administrative Review Board b.FECA Claims Administration c.Occupational Safety and Health Review Commission © 2025 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 

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Solution and Answer Guide: Michelle A. Green, Understanding Health Insurance: A Guide to Billing and Reimbursement: 2025, 20th Edition, 9798214112978; Chapter 16: Workers’ Compensation d.Office of Workers’ Compensation Programs

ANS: b

Analysis:

a.Incorrect. The federal Department of Labor’s Administrative Review Board issues agency decisions in cases arising from worker protection laws, including whistleblower and public contract laws. The Division of Federal Employees’ Compensation (DFEC), FECA Claims Administration adjudicates new claims for program benefits (and manages ongoing cases).b.Correct. The Division of Federal Employees’ Compensation (DFEC), Federal Employees’ Compensation Act (FECA) Claims Administration adjudicates new claims for program benefits (and manages ongoing cases).c.Incorrect. The Occupational Safety and Health Review Commission is an independent federal agency that functions as a two-tiered administrative court to conduct hearings, receive evidence, and render decisions by Administrative Law Judges (ALJs); it also conducts discretionary reviews of ALJ decisions. The Division of Federal Employees’ Compensation (DFEC), FECA Claims Administration adjudicates new claims for program benefits (and manages ongoing cases).d.Incorrect. The Office of Workers’ Compensation Programs administers disability compensation programs that provide wage-replacement benefits, medical treatment, vocational rehabilitation, and other benefits to federal workers (or eligible dependents) injured at work or who acquire an occupational disease. The Division of Federal Employees’ Compensation (DFEC), FECA Claims Administration adjudicates new claims for program benefits (and manages ongoing cases).

5.The Employees’ Compensation Appeals Board (ECAB) hears and decides cases on appeal from decisions of the Office of Workers’ Compensation Programs (OWCP) in an impartial and expeditious manner. Prior to review of the case record by the ECAB, injured federal workers have the opportunity for a full evidentiary hearing with the OWCB a.adjudication mediation.b.arbitration intercession.c.branch of hearings and review.d.claims administration.

ANS: c

© 2025 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 

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