Study sets, textbooks, questions
Upgrade to remove ads
Chapter 2 Introduction to Health Insurance Workbook 2.3 and 2.5 and textbook Review Questions
Understanding Health Insurance
Terms in this set (40)
Evidence of the first health insurance policy to provide private health care coverage for injuries did not result in death, appeared in which year?
Which has as it's goal access to health coverage for every individual, regardless of the system implemented to achieve that goal?
Universal health insurance
The terms electronic health record EHR electronic medical record EHR are often used interchangeably, but the___ is a more globally concept that includes the collection of patient information documented by a number of providers at different facilities regarding one patient.
Electronic health record
Current Procedural Terminology CPT was developed by which organization in 1966?
American Medical Association
Total practice management software (TPMS) is used to generate the EMR, automating which of the following medical practice functions?
If a veteran is rated at 100% permanently and totally disabled as a result of a service connected condition, which program will provide benefits to the Veteran's dependents?
Which coding system was created in 1984?
A new see schedule for Medicare services was implemented as part of OBRA in 1989 and 1990, replacing the regional "usual and reasonable" payment basis with a fixed fee scheduled called?
Quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the tests are performed were established specifically by ____ legislation.
CMS developed the National Correct Coding
Initiative (NCCI) to?
eliminate improper coding and promote National correct coding methodologies.
The skilled nursing facility prospective payment system (SNFPPS) generates____ payments for each skilled nursing facility admission.
In 2000, which type of Health Plan was introduced as a way to encourage individuals to locate the best health care at the lowest price possible, with the goal of holding down health care cost?
By whom is the employer identification number (EIN) assigned?
Internal Revenue Service
The systematic method of documentation that consists of four components (database, problem list, initial plan, and progress notes) is called the?
problem oriented record
The primary purpose of the record is to provide for____, which involves documenting patient care services so that others who treat the patience have a source of information to assist with additional care and treatment.
continuity of care
Which would be considered a Medicare meaningful EHR user if it can demonstrate that certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of healthcare?
Physicians receive decreased Medicare Part B payments beginning in ____ if they were eligible to be meaningful EHR users by 2015 but did not implement an electronic health record (EHR).
In a teaching hospital, general documentation guidelines allow ____ to document physician services in the patient's medical record.
both residents and teaching physicians
The patient protection and Affordable Care Act (PPACA) amended the time for filing Medicare fee-for-service claims to ___ calendar year(s) after the date of service as the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.
The Health Care and Education Reconciliation Act (HCERA) amended PACA to implement health care reform initiatives, which____ tax credits for individuals so they could purchase health care insurance.
Which was the first commercial insurance company in the United States to provide private health care coverage for injuries not resulting in death?
Franklin Health Assurance Company
The problem-oriented record (POR) includes the following four components:
database, problem list, initial plan, progress notes
Which is a primary purpose of the patient record?
ensure continuity care
Which replaced the 1908 workers' compensation legislation and provided civilian employees of the federal government with medical care, survivors' benefits, and compensation for lost wages?
Federal Employees' Compensation Act
The first Blue Cross policy was introduced by?
Baylor University in Dallas, Texas
The Blue Shield concept grew out of the lumber and mining camps of the _____ region at the turn of the century.
Major medical insurance provides coverage for _____ illnesses and injuries, incorporating large deductibles and lifetime maximum amounts.
catastrophic or prolonged
The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) enacted the _____ prospective payment system (PPS).
diagnosis- related groups
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results?
regardless of where the test was performed
The National Correct Coding Initiative promotes national correct coding methodologies and eliminates improper coding. NCCI edits are developed based on coding conventions defined in _____, current standards of medical and surgical coding practice, input from specialty societies, and analysis of current coding practice.
When patient states, "I haven't been able to sleep for weeks," the provider who uses the SOAP format documents that statement in the _____ portion of the clinic note.
The provider who uses the SOAP format documents the physical examination in the _____ portion of the clinic note.
The percentage of costs a patient shares with the health plan (e.g. plan pay 80 percent of costs and patient pays 20 percent) is called?
Health Care coverage offered by ___ is called group health insurance
The Hill-Burton Act provided federal grants for modernizing hospitals that had become obsolete because of a lack of capital investment during the Great Depression and WWII (1929 to 1945). In return for federal funds,?
facilities were required to provide services free or at reduced rates to patients unable to pay for care
Third-party administrators (TPAs) administer health care plans and process claims, serving as a?
system of checks and balances for labor and management
The government health plan that provides healthcare services to Americans over the age of 65 is called?
The primary intent of HIPAA legislation is to?
create better access to health insurance, limit fraud and abuse, and reduce administrative costs.
The electronic health record (EHR) allows patient information to be created at different locations according to a unique patient identifier or identification number, which is called?
The Patient Protection and Affordable Care Act (PPACA) was signed into federal law by President Obama on March 23 2010, and resulted in created of a(n)?
health insurance marketplace
What is medicare Part B and what does it cover?
Under the HIPAA administrative Simplification Legislation,Each healthcare provider was assigned a unique identification number known as
It is important to know the source of the files you open on your office computer because hackers can introduce malware to the system, which can result in patient records being held hostage and ransom being demanded.
Central registry XY manually evaluating every 10th abstract from each batch of abstracts submitted to them by reporting hospitals. This process is:
Sets with similar terms
Insurance Chapter 2
Chapter 2 & 3 Introduction to Health Insurance cha…
Chapter 2 & 3 Introduction to Health Insurance cha…
ch 2 quick check