← Health Insurance Test
5 Written Questions
5 Matching Questions
- First Blue Cross policy:
- Current Procedural Terminology (CPT) is developed:
- Managed Care Organizations (MCO):
- Primary Care Providers (PCP):
- a is responsible for the health of a group of enrollees & can be a health plan.
- b introduced a plan to guarantee school teachers 21 days of hospital care for 46 a year.
- c by American Medical Association in 1966
- d is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
- e person in whose name the insurance policy is issued
5 Multiple Choice Questions
- World Health Organization (WHO) in 1948
- they paid monthly fees to medical service bureaus, which were composed of groups of physicians
- the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid
- provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis
5 True/False Questions
Preferred Provider Organization (PPO): → contracted network of healthcare providers that provide care to subscribers for a discounted fee.
Preauthorization: → provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)
International Classification of Diseases (ICD): → a classification system used to collect data for statistical purposes
Exclusive Provider Organization (EPO): → provides benefits to subscribers who are required to receive services from network providers
COBRA in 1985: → provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.