5 Written questions
5 Matching questions
- 1984 Standardization of information submitted on Medicare claims:
- COBRA in 1985:
- Health Maintenance Organization (HMO):
- a grants prior approval for reimbursement of a healthcare service
- b person in whose name the insurance policy is issued
- c The Consolidated Omnibus Budget Reconciliation Act allows employees to continue healthcare coverage beyond the benefit termination date.
- d HCFA (now called CMS) required providers to use the HCFA-1500 (now called the CMS-1500) to submit Medicare claims
- e provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis
5 Multiple choice questions
- review for medical necessity of inpatient care prior to admission
- prospective payment system that reimburses hospitals for impatient stays
- provides benefits to subscribers who are required to receive services from network providers
- amount for which the patient is financially responsible before insurance policy provides coverage
5 True/False questions
Discharge planning: → arranging appropriate healthcare services for discharged patients.
Preferred provider Organization (PPO): → provides benefits to subscribers who are required to receive services from network providers
What year First Blue Cross policy started: → 1939
Integrated Delivery System (IDS): → organization of affiliated providers' sites that offer joint healthcare services to subscribers
HIPPA is to: → provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.