5 Written questions
5 Matching questions
- Managed Care
- Utilization Management
- Internal Classification of Diseases, Revision, Clinical Modification (ICD)
- Walkout Statement
- Member Physician
- a The coding system used to document diseases, injuries, illness and mortalities.
- b A panel that tracks what their members receive and checks if their medical care meets the standards of the organization.
- c A printed form with the pt's charges and the amt. paid for the servces rendered, which the pt takes with her. (receipt)
- d A physician who has contacted to participate with an insurance company to be reimbursed for services according to the company's plan.
- e A system of medical team members organized into groups to provide quality and cost-effective care that encompasses both the delivery of health care and payment of the services.
5 Multiple choice questions
- Private insurance to supplement Medicare benefits for noncovered services.
- The person who has been insured, and insurance policy holder.
- A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
- This plan offers different insurance coverage depending on whether the pt receives services from a contracting network or non-network physician. The benefits are higher if the physician provider is a member of the PPO (or is a network physician).
- Insurance purchased by an individual for self and any eligible dependents.
5 True/False questions
Coodination of Benefits (COB) → A printed description of the benefits provided by the insurer to the beneficiary.
Preadmission Testing (PAT) → Routine tests required for all pt's before hospital admission to screen for abnormal findings that could interfere with the pt's hospital stay or scheduled procedure.
Gatekeeper → The person who has been insured, and insurance policy holder.
Coding → Transference of words into numbers to facilitate the use of computers in claim processing.
Assignment of Benefits → A printed description of the benefits provided by the insurer to the beneficiary.