Ms. Moneybags Understanding Health Insurance. -Intro to H.I. ch.2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Insurance | Contract that protects the insured from loss
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| PIP | Personal Injury Protection
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| Disability Insurance | reimbursement for income lost as a result of a temporary or permanent illness or injury
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| Liability Insurance | policy that covers losses to a third party caused by the insured, object owned by the indured or on premises owned by insured
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| FECA | Federal Employees Compensation Act
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| Date of the first health insurance policy | 1860
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| Date of first Blue Cross Policy | 1929
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| Date of first Blue Shield Plan | 1939
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| Group health Insurance | health care coverage available through employers and other organizations. Employers usually pay part or all of premium costs
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| Hill Burton Act | provided federal grants for modernizing hospitals that had become obsolete during Great Depressiona and WWII. In return, facilities were required to provide free or reduced service to patients unable to pay for care
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| TPA | Thrid Party Administrators
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| Third Party Administrators | administer health care plans and process claims, serving as checks and balance system for laboar and management
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| WHO | World Health Organization
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| Inpatient | Patient admitted to hospital with the expectation of staying atleast 24 or more
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| SSA | Social security Administration
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| Date of implementation of SSA Amendments for Medicare and Medicaid | 1966
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| CHAMPUS | Civilian Health And Medical Program-Uniformed Services
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| OSHA | Occupational Safety and Health Administration Act of 1970
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| Occupational Safety and Health Administration Act of 1970 | protects all employees against injuries from occupational hazards in the workplace
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| CHAMPVA | Civilian Health and Medical Program of the Department of Veterans Affairs
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| HMO's | Health Maintenance Organizations
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| ERISA | Employee Retirement Income Security Act of 1974
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| HCFA | Health Care Financing Adminstration, replaced by CMS
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| DHHS | Department of Health and Human Services
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| PSRO's | Professional Standards Review Organizations, replaced by PRO's
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| PRO's | Peer Review organizations
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| CMS | Centers for Medicare and Medicaid Services
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| PPS | Prospective Payment System
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| per diem reimbursement | per day charge
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| DRG | Diagnosis Related Groups
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| COBRA | Consolidated Omnibus Budget Reconciliation Act of 1985
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| Consolidated Omnibus Budget Reconciliation Act of 1985 | allows employees to continue health care coverage beyond the benefit termination date
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| CLIA | Clinical Laboratories Improvement Act
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| NCQA | National Committeee for Quality Assurance. they developed HEDIS
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| HEDIS | Health Plan Employer Data and Information SET
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| Health Plan Employer Data and Information SET | created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance managed health care plans
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| RBRVS | Resource Based Relative value Scale System
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| Usual and Resonable payments | based on fees typically charged by providers by specialty within a particular region of the country
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| NCCI | National Correct Coding Initiative
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| National Correct Coding Initiative | developed to promote national correct coding methodologies and to eliminate improper coding
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