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Insure3

Question	Answer
a coordination of benifits statement in an insurance policy refers to the waiting period	False
The effecient medical insurance specialist usually groups together all outstanding charges of patients who have the same type of insurance and processes these insurance claims at the same time	True
When the insured is required to pay a percentage of the covered service costs, this is referred to as coinsurance	True
when does the physician/ patient contract begin?	when the doctor accepts the patient and agrees to treat the patient
MOST PHYSICIANS/PATIENTS CONTRACTS ARE	implied
WHEN A PATIENT CARRIES PRIVATE MEDICAL INSURANCE, THE CONTRACT FOR TREATMENT EXISTS BETWEEN?	the physician and the patient
who does the contract exist between in a workers compensation case?	the physician and the insurance company
in health insurance, the insured is also known as?	the subscriber, member & policyholder
THE REASON FOR A COORDINATION OF BENIFITS STATEMENT IN A HEALTH INSURANCE POLICY IS	to prevent duplication or overlapping of payments for the same medical expenses
when a medical facility is sent correct reimbursement from an insurance company for professional services the site recieves?	indemnity, payment and check
According to the Birthday Law, if both the mom and dad have the same Birthday...	the plan of the person who has coverage is the primary payer
Conditions that existed and were treated before the health insurancepolicy was issued are called?	preexisting
An attachment to an insurance policy that excludes certain illnesses or disabilities that would otherwise be covered is referred to as an	waiver
What is the correct term used to determine if a procedure is covered and medically necessary	Preauthorization
Mrs Tompsett leaves her place of employment. she is eligible to transfer her medical insurance coverage from a group to an individual contract. This is known as	conversion privilege
WHY WOULD CONVERSION FROM A GROUP POLICY TO AN INDIVIDUAL POLICY BE ADVANTAGEOUS	no physical examination required
MR. OTT WAS LAID OFF FROM HIS JOB. HE IS PROTECTED BY COBRA, WHICH REQUIRES HIS EMLOYER TO	extend group health insurance policies for 18 months
A state and Federal program for children who are younger than 21 years of age and have special health care needs is	Maternal and Child Health Programs (MCHP)
A PATIENT INTAKE SHEET IS ALSO CALLED	Patient registration form
An encounter form may also be known as a	patient service slip
THE SOURCE DOCUMENT FOR INSURANCE CLAIM DATA IS THE	superbill
A DAILY RECORD SHEET USED TO RECORD DAILY BUSINESS TRANSACTIONS IS CALLED A	Day Sheet
WHEN THE PHYSICIAN SERVICES HAVE BEEN SUBMITTED TO THE PATIENTS INSURANCE COMPANY BY THE PHYSICIANS OFFICE, THE PATIENT SHOULD	Be sent a monthly statement indicating the insurance company has been billed
The amount that must be paid each year by the insured before policy benifits begin is known as	deductible
MANY HEALTH INSURANCE CLAIM FORMS CONTAIN A ___________ OF BENIFITS STATEMENT THAT DIRECTS THE INSURANCE COMPANY TO PAY BENIFITS DIRECTLY TO THE PROVIDER OF CARE ON WHOSE CHARGE THE CLAIM IS BASED	Assignment
Government sponsered programs that provides hospital and medical services for dependents of active duty. uniformed service members, military retirees and their families, and suvivors of uniformed services.	Tricare
PROVIDES COVERAGE FOR SPOUSES AND CHILDREN OF VETERANS WITH TOTAL, PERMANENT SERVICE-CONNECTED DISABILITIES OR FOR THE SURVIVING SPOUSES AND CHILDREN OF VETERANS WHO DIED AS A RESULT OF SERVICE-CONNECTED DISABILITIES	CHAMPVA
A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result in Illness, injury, or disease.	Disability Income Insurance
AN ORGANIZATION THAT PROVIDES A WIDE RANGE OF COMPREHENSIVE HEALTH CARE SERVICES FOR A SPECIFIED GROUP AT A FIXED PERIODIC PAYMENT	Health maintence organization (HMO)
A PROGRAM SPONSERED JOINTLY BY FEDERAL AND STATE GOVERNMENTS FOR MEDICALLY INDIGENT PERSON AGED INDIVIDUALS WHO MEET CERTAIN FINANCIAL REQUIREMENTS AND DISABLED.	Medicaid
THE HOSPITAL INSURANCE SYSTEM AND SUPPLEMENTARY MEDICAL INSURANCE FOR THOSE OLDER THAN 65 YEARS OF AGE, CREATED BY THE 1965 AMENDMENTS TO THE SOCIAL SECURITY ACT	Medicare
A contract that insures a person against on-the-job injury or illness	Workers Compensation insurance

Created by: Lea99

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