5 Written Questions
5 Matching Questions
- Point-of-Service Plan (POS):
- COBRA in 1985:
- What year for Group Health Insurance:
- Health Maintenance Organization came in effect in
- Health Insurance Portability & Accountability Act of 1996 (HIPPA):
- a mandates regulations that govern privacy, security, & electronic transactions standards for healthcare information.
- b The Consolidated Omnibus Budget Reconciliation Act allows employees to continue healthcare coverage beyond the benefit termination date.
- c patients are free to use the managed care panel of providers or self-refer to non-managed care providers
- d 1973
- e 1940's
5 Multiple Choice Questions
- provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis
- World Health Organization (WHO) in 1948
- 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
- HCFA (now called CMS) required providers to use the HCFA-1500 (now called the CMS-1500) to submit Medicare claims
- 1908 - workmen compensation
5 True/False Questions
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
Current Procedural Terminology (CPT) is developed: → organization of affiliated providers' sites that offer joint healthcare services to subscribers
Coinsurance: → the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid
Managed Care Organizations (MCO): → network of physicians & hospitals that have joined together to contract w/insurance companies, employers.
Utilization review: → review for medical necessity of inpatient care prior to admission