5 Written Questions
5 Matching Questions
- medical necessity
- managed care
- procedure code
- a part of changes that of changes that an insured person must pay for health care services after payment of the deductible amount
- b a type of insurance in which the carrier is responsible for both financing and the delivery of health care
- c treament provided by a physycian to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice.
- d a code that identifies a medical service.
- e health plan that repays the policyholder for covered medical expenses
5 Multiple Choice Questions
- adavance payments to a provider that covers each plan member's health care services for a certain period of time
- process of assigning standardize codes to diagnises and procedures
- form that includes a patient's personal, employment, and insurance data needed to complete an insurance
- a list of all services performed for a patient, along with the charges for each service.
- a plan, program, or organization that provides health benifits.
5 True/False Questions
consumer-driven health plan (CDPH) → a plan, program, or organization that provides health benifits.
preferred provider organization (PPO) → .managed care network of health care providers who agree to perform services for plan members at discounted fees
health maintenance organization (HMO) → a managed health care system in which provides agree to offer heath care to the organization's members for fixed periodic payments from paln
payer → private or government organization that insures or pays for health care on the behalf of beneficiaries.
adjudication → adavance payments to a provider that covers each plan member's health care services for a certain period of time