Insure3
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| a coordination of benifits statement in an insurance policy refers to the waiting period | False
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| The effecient medical insurance specialist usually groups together all outstanding charges of patients who have the same type of insurance and processes these insurance claims at the same time | True
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| When the insured is required to pay a percentage of the covered service costs, this is referred to as coinsurance | True
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| when does the physician/ patient contract begin? | when the doctor accepts the patient and agrees to treat the patient
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| MOST PHYSICIANS/PATIENTS CONTRACTS ARE | implied
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| WHEN A PATIENT CARRIES PRIVATE MEDICAL INSURANCE, THE CONTRACT FOR TREATMENT EXISTS BETWEEN? | the physician and the patient
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| who does the contract exist between in a workers compensation case? | the physician and the insurance company
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| in health insurance, the insured is also known as? | the subscriber, member & policyholder
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| THE REASON FOR A COORDINATION OF BENIFITS STATEMENT IN A HEALTH INSURANCE POLICY IS | to prevent duplication or overlapping of payments for the same medical expenses
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| when a medical facility is sent correct reimbursement from an insurance company for professional services the site recieves? | indemnity, payment and check
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| According to the Birthday Law, if both the mom and dad have the same Birthday... | the plan of the person who has coverage is the primary payer
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| Conditions that existed and were treated before the health insurancepolicy was issued are called? | preexisting
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| An attachment to an insurance policy that excludes certain illnesses or disabilities that would otherwise be covered is referred to as an | waiver
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| What is the correct term used to determine if a procedure is covered and medically necessary | Preauthorization
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| Mrs Tompsett leaves her place of employment. she is eligible to transfer her medical insurance coverage from a group to an individual contract. This is known as | conversion privilege
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| WHY WOULD CONVERSION FROM A GROUP POLICY TO AN INDIVIDUAL POLICY BE ADVANTAGEOUS | no physical examination required
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| MR. OTT WAS LAID OFF FROM HIS JOB. HE IS PROTECTED BY COBRA, WHICH REQUIRES HIS EMLOYER TO | extend group health insurance policies for 18 months
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| A state and Federal program for children who are younger than 21 years of age and have special health care needs is | Maternal and Child Health Programs (MCHP)
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| A PATIENT INTAKE SHEET IS ALSO CALLED | Patient registration form
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| An encounter form may also be known as a | patient service slip
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| THE SOURCE DOCUMENT FOR INSURANCE CLAIM DATA IS THE | superbill
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| A DAILY RECORD SHEET USED TO RECORD DAILY BUSINESS TRANSACTIONS IS CALLED A | Day Sheet
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| WHEN THE PHYSICIAN SERVICES HAVE BEEN SUBMITTED TO THE PATIENTS INSURANCE COMPANY BY THE PHYSICIANS OFFICE, THE PATIENT SHOULD | Be sent a monthly statement indicating the insurance company has been billed
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| The amount that must be paid each year by the insured before policy benifits begin is known as | deductible
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| MANY HEALTH INSURANCE CLAIM FORMS CONTAIN A ___________ OF BENIFITS STATEMENT THAT DIRECTS THE INSURANCE COMPANY TO PAY BENIFITS DIRECTLY TO THE PROVIDER OF CARE ON WHOSE CHARGE THE CLAIM IS BASED | Assignment
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| Government sponsered programs that provides hospital and medical services for dependents of active duty. uniformed service members, military retirees and their families, and suvivors of uniformed services. | Tricare
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| PROVIDES COVERAGE FOR SPOUSES AND CHILDREN OF VETERANS WITH TOTAL, PERMANENT SERVICE-CONNECTED DISABILITIES OR FOR THE SURVIVING SPOUSES AND CHILDREN OF VETERANS WHO DIED AS A RESULT OF SERVICE-CONNECTED DISABILITIES | CHAMPVA
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| A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result in Illness, injury, or disease. | Disability Income Insurance
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| AN ORGANIZATION THAT PROVIDES A WIDE RANGE OF COMPREHENSIVE HEALTH CARE SERVICES FOR A SPECIFIED GROUP AT A FIXED PERIODIC PAYMENT | Health maintence organization (HMO)
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| A PROGRAM SPONSERED JOINTLY BY FEDERAL AND STATE GOVERNMENTS FOR MEDICALLY INDIGENT PERSON AGED INDIVIDUALS WHO MEET CERTAIN FINANCIAL REQUIREMENTS AND DISABLED. | Medicaid
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| THE HOSPITAL INSURANCE SYSTEM AND SUPPLEMENTARY MEDICAL INSURANCE FOR THOSE OLDER THAN 65 YEARS OF AGE, CREATED BY THE 1965 AMENDMENTS TO THE SOCIAL SECURITY ACT | Medicare
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| A contract that insures a person against on-the-job injury or illness | Workers Compensation insurance
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Created by:
Lea99