Health Insurance today Chapter 11,
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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| A well defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further treatment | show 🗑
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| This occurs when a physician in the community refers a patient to the hospital for observation, bypassing the clinic or emergency department | show 🗑
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| Usually covers the deductible and copay or coinsurance of a primary health insurance policy | show 🗑
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| show | billing entity
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| show | medigap
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| show | federal employee health benefits program (FEHBP)
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| show | bluecard program
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| Special clauses stipulating additional coverage over and above the standard contract | show 🗑
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| show | idemnity coverage
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| The amount commonly charged for a particular medical service by providers within a particular geographic region for establishing their allowable rates | show 🗑
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| HIPAA privacy standards require providers to notify patients about their right to | show 🗑
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| Development of an insurance claim begins when the: | show 🗑
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| When a fee submitted to an insurance company is higher than the health care provider's normal fee for the coded procedure,the provider must: | show 🗑
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| show | CMS 1500 claim form was developed
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| When typewritten data is CMS-1500 claim form runs over into adjacent blocks, the claim will be: | show 🗑
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| Which is the proper way to prepare a rejected claim for resubmission? | show 🗑
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| Remittance advice forms that are organized and filed according to month and payer are: | show 🗑
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| show | noncapitated
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| show | supplemental
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| show | physician services
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| Blue Cross facilities that had signed contracts to provide services to subscribers for special rates were known as_______hospitals | show 🗑
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| show | national advertising
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| show | 10 percent lower than the participating provider rate
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| Small businesses are likely to select which BCBS coverage? | show 🗑
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| What is an example of a benefit covered by BCBS basic coverage? | show 🗑
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| show | indemnity coverage
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| The outpatient pretreatment authorization plan (OPAP) is also known as: | show 🗑
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| show | government-wide service benefit plan
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| show | medigap
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| show | preferred provider network
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| show | obtain payment for the full fee charged
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| show | hospitalizations
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| Which is considered a service reimbursed by BCBS major medical coverage? | show 🗑
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| Which is a special clause in an insurance contract that stipulates additional coverage over and over and above the standard contract? | show 🗑
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| show | outpatient pretreatment authorization
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kduvall20
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