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of 45 available terms

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5 Written Questions

5 Matching Questions

  1. Point-of-Service Plan (POS):
  2. COBRA in 1985:
  3. What year for Group Health Insurance:
  4. Health Maintenance Organization came in effect in
  5. Health Insurance Portability & Accountability Act of 1996 (HIPPA):
  1. a mandates regulations that govern privacy, security, & electronic transactions standards for healthcare information.
  2. b The Consolidated Omnibus Budget Reconciliation Act allows employees to continue healthcare coverage beyond the benefit termination date.
  3. c patients are free to use the managed care panel of providers or self-refer to non-managed care providers
  4. d 1973
  5. e 1940's

5 Multiple Choice Questions

  1. provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis
  2. World Health Organization (WHO) in 1948
  3. 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
  4. HCFA (now called CMS) required providers to use the HCFA-1500 (now called the CMS-1500) to submit Medicare claims
  5. 1908 - workmen compensation

5 True/False Questions

  1. Capitation: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

          

  2. Current Procedural Terminology (CPT) is developed:organization of affiliated providers' sites that offer joint healthcare services to subscribers

          

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

          

  4. Managed Care Organizations (MCO):network of physicians & hospitals that have joined together to contract w/insurance companies, employers.

          

  5. Utilization review:review for medical necessity of inpatient care prior to admission

          

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