5 Written questions
5 Matching questions
- Who developed ICD:
- Preferred Provider Organization (PPO):
- First Health Insurance Policy in
- Utilization review:
- 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.
- b World Health Organization (WHO) in 1948
- c contracted network of healthcare providers that provide care to subscribers for a discounted fee.
- d method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case
- e grants prior approval for reimbursement of a healthcare service
5 Multiple choice questions
- 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.
- provides benefits to subscribers who are required to receive services from network providers
- a classification system used to collect data for statistical purposes
- 1908 - workmen compensation
- patients are free to use the managed care panel of providers or self-refer to non-managed care providers
5 True/False questions
DRG's: → amount for which the patient is financially responsible before insurance policy provides coverage
What year First Blue Cross policy started: → 1929
Preauthorization: → prior approval
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
Coinsurance: → the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid