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HIT Chapter 6 MC
Multiple Choice
| Question | Answer |
|---|---|
| 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 |
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