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5 Written questions

5 Matching questions

  1. Who developed ICD:
  2. Preauthorization:
  3. Preferred Provider Organization (PPO):
  4. First Health Insurance Policy in
  5. Utilization review:
  1. a 1860 by The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the US to provide private healthcare coverage for injuries not resulting in death.
  2. b World Health Organization (WHO) in 1948
  3. c contracted network of healthcare providers that provide care to subscribers for a discounted fee.
  4. d method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case
  5. e grants prior approval for reimbursement of a healthcare service

5 Multiple choice questions

  1. Established quality standards for all laboratory testing to ensure the accuracy, reliability, and timelines of patient test results regardless of where the test was performed.
  2. provides benefits to subscribers who are required to receive services from network providers
  3. a classification system used to collect data for statistical purposes
  4. 1908 - workmen compensation
  5. patients are free to use the managed care panel of providers or self-refer to non-managed care providers

5 True/False questions

  1. DRG's:amount for which the patient is financially responsible before insurance policy provides coverage


  2. What year First Blue Cross policy started:1929


  3. Preauthorization:prior approval


  4. Copayment:provision in an insurance policy that requires the policy holder or patient to pay a specified dollar amount to a healthcare provider for each visit or medical service received


  5. Coinsurance:the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid


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