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HIT Chapter 6 MC

Multiple Choice

The type of health insurance that offers the most choices of providers, in which pts can choose any provider they want and can change at any time FFS and Indemnity Plan
An example of a third party payer Commercial Insurance company, BCBS, Medicare/Medicaid
Group insurance typically is A contract between and insurance company and an employer
The type of insurance that comprises a group of providers who share the financial risk of the plan or who have an incentive to deliver cost-effective, but quality service Managed care plan
The best type of healthcare plan is There is not one best type
Most FFS plans include the pt paying a Yearly Deductible, periodic payment (premium), Per-vist coinsurance
The typical levels of coverage in an ffs plan include Basic/major medical/comprehensive
With FFS insurance which of the following is typically true The higher the deductible, the lower the premium
The amount of money the policy holder has to pay out-of-pocket for any one incident or any 1 year is limited by an Insurance cap
When the fee charged by a provider falls within a parameters of the fee commonly charged for the particular service within a specific geographic area it is said to be reasonable and customary
A provider who signs a contractual arrangement with a third party payer contractor and agrees to accept the amount paid by the carrier as payment in full is referred to as a PAR
The government health insurance program that provides coverage for its own civilian employees is called FEHB
When the employer--not an insurance company--is responsible for the cost of its employees' medical services, the employer has a Self insured program
The federal law designed to protect the rights of beneficiaries of employee benefit plans offered by employers and the sets minimum standards for pension plans in private industry is called ERISA
A person or organization that processes claims and performs other contractual administrative services is commonly referred to as a TPA
Created by: 1279370503