← Terms Test
5 Written Questions
5 Matching Questions
- Group Insurance
- Preexisting Condition
- Third Party Payer
- Workers Compensation
- Walkout Statement
- a A printed form with the pt's charges and the amt. paid for the servces rendered, which the pt takes with her. (receipt)
- b Government program that provides insurance coverage for those who are injured on the job or who have developed work related disorders, disabilities or illnesses.
- c Insurance Carrier.
- d A condition that existed before the insured's policy was issued.
- e Insurance offered to all employees by and employer.
5 Multiple Choice Questions
- A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
- This plan offers different insurance coverage depending on whether the pt receives services from a contracting network or non-network physician. The benefits are higher if the physician provider is a member of the PPO (or is a network physician).
- The standard claim form
- A request for payment.
- Prior authorization must be obtained before the pt is admitted to the hospital or some specified outpatient or in-office procedures.
5 True/False Questions
Managed Care → A system of medical team members organized into groups to provide quality and cost-effective care that encompasses both the delivery of health care and payment of the services.
Accounts Payable → The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
Member Physician → A physician who has contacted to participate with an insurance company to be reimbursed for services according to the company's plan.
Individual Insurance → Insurance purchased by an individual for self and any eligible dependents.
Utilization Review → A panel that tracks what their members receive and checks if their medical care meets the standards of the organization.