Theory TEST
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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| Many employed individuals obtain healthcare coverage through a/an | group plan
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| A special tax shelter set up for the purpose of paying medical bills is a/an | medical savings account
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| Actuaries use statistics to predict anticipated healthcare costs, which establish | premiums
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| The two new types of healthcare plans mentioned in the text that are “on the horizon” are | Health Insurance Exchanges and Accountable Care Organizations
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| The federal act that states that Medicare is the secondary payer in the case of automobile or liability coverage is the | Federal Omnibus Budget Reconciliation Act of 1980
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| Health insurance narrows down undesirable events to | illnesses and injuries
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| The act that made Medicare benefits secondary to employer group health plans for employees (or spouses) older than 65 is the | Tax Equity and Fiscal Responsibility Act of 1982
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| When an individual is eligible for coverage under two different health insurance policies, ________ typically governs payment. | coordination of benefits
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| A relatively new concept of healthcare structure that emerged in the late 20th century is | managed care
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| An insurance contract made with a business entity that covers its employees equally is called a/an | group contract
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| Upcoding and unbundling of charges are examples of | healthcare fraud
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| Exceptions to confidentiality include all of the following except | emergency treatment
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| When both basic and major medical coverage is combined into one insurance plan, it is called | a comprehensive plan
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| A health insurance company is referred to as the _____ party. | third
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| Most third-party payers do not pay for medical services that are | not medically necessary
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| When an individual purchases a healthcare policy from a commercial insurer, he or she is said to have a/an | individual contract
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| Members of a medical team who are not physicians are called _____ members. | ancillary
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| An authorization to release information should contain all of the following except the | primary diagnosis
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| A contract can be terminated when | both parties agree to terminate it &
either party defaults on the provisions
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| The traditional kind of health insurance wherein patients can choose any provider or hospital they wish and change physicians at will is | indemnity & fee-for-service
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| In compliance with HIPAA, when patients visit their healthcare providers for treatment, they are given a/an | privacy statement
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| Identify which of the following is not a valid way to prevent fraud and abuse in the medical office. | discuss potential problems with law enforcement professionals
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| Elements of a legal contract include all of the following except | an attorney
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| Insurance payments are typically based on | UCR rates
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| The type of contract that exists between a healthcare provider and a patient is a/an _____ contract. | implied
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