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 |