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5 Written Questions

5 Matching Questions

  1. SOAP stands for:
  2. Preauthorization:
  3. Who developed ICD:
  4. What year Blue Shield started:
  5. International Classification of Diseases (ICD):
  1. a a classification system used to collect data for statistical purposes
  2. b 1939
  3. c prior approval
  4. d S-Subjective
  5. e World Health Organization (WHO) in 1948

5 Multiple Choice Questions

  1. by American Medical Association in 1966
  2. contracted network of healthcare providers that provide care to subscribers for a discounted fee.
  3. 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.
  4. provides benefits to subscribers who are required to receive services from network providers
  5. PPO

5 True/False Questions

  1. COBRA in 1985:The Consolidated Omnibus Budget Reconciliation Act allows employees to continue healthcare coverage beyond the benefit termination date.


  2. Fee-for-service:the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid


  3. Gatekeeper:providing essential healthcare services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists.


  4. Major medical:provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)


  5. 1984 Standardization of information submitted on Medicare claims:HCFA (now called CMS) required providers to use the HCFA-1500 (now called the CMS-1500) to submit Medicare claims


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