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Med. Insurance Terms

Medical Insurance in a Flash Chapter 7

In what year was the first health insurance initiated? 1694
What are the two challenges facing insurance companies? Adverse selection and moral hazard
What is the purpose of health insurance? To help patients pay for medical care
What types of tests are considered preventive medicine? Pap smears,mammograms,PSA tests,and colonoscopies
Patient + Health Insurance + Primary Care Physician = ? A healthier patient
What are the two categories of health insurance? Individual and group
What other services are offered by the medical benefits of your insurance plan? Vision, dental, and prescriptions
What is the term for the payment of group health insurance? A premium
Patients paying individual insurance premiums may be able to use what state benefit? A tax benefit
What professionals may need to carry their own individual insurance? Hairdressers, real estate agents, and self-employed psychologists or accountants, to name a few
Name the two types of private health insurance. Employment and direct purchase
Name three types of government health insurance. Medicare,medicaid,and TRICARE
What department within DHHS handles drug approvals? FDA
What department within DHHS deals with issues on againg? AOA
What professions are required to obtain a license before practicing? Physicians,nurses,dentist, and psychologits, to the name a few
What is the percentage of billing and coding positions that are unfilled in the United States? 18%
What insurance covers costs incurred by insurance companies arising out of a billing mistake? Erros and ommissions insurance
A billing/insurance specialist in a physician practice should be knowledgeablen in the completion of what insurance form? CMS 1500 form
Diagnosis codes are found in what coding book? ICD-9-CM book
What insurance plan is desingned for the needy? Medicaid
CMS falls under what federal executive deparment? Deparment of Health and Human Services
What type of plan provides coverange through an individual from a private company? Direct purchase plan
Who formend the first health insurance? Hugh chamberlen
What healthcare plan provides medical assistance to eligible Native Americas? The Indian Health service
What percentage of the allowed amount is paid by medicare? 80%
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