5 Written questions
5 Matching questions
- Clinical Laboratory Improvement Act (CLIA):
- Occupational Safety & Health Administration Act (OSHA):
- Primary Care Providers (PCP):
- What year Blue Shield started:
- Concurrent review:
- a 1939
- b 1970
- c 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.
- d is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
- e review for medical necessity of tests/procedures ordered during inpatient hospitalization
5 Multiple choice questions
- 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.
- mandates regulations that govern privacy, security, & electronic transactions standards for healthcare information.
- arranging appropriate healthcare services for discharged patients.
- network of physicians & hospitals that have joined together to contract w/insurance companies, employers.
5 True/False questions
Managed Care Organizations (MCO): → is responsible for the health of a group of enrollees & can be a health plan.
Preauthorization: → provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)
Exclusive Provider Organization (EPO): → contracted network of healthcare providers that provide care to subscribers for a discounted fee.
HIPPA is to: → provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.
COBRA in 1985: → provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.