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5 Written questions

5 Matching questions

  1. Clinical Laboratory Improvement Act (CLIA):
  2. Occupational Safety & Health Administration Act (OSHA):
  3. Primary Care Providers (PCP):
  4. What year Blue Shield started:
  5. Concurrent review:
  1. a 1939
  2. b 1970
  3. 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.
  4. d is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
  5. e review for medical necessity of tests/procedures ordered during inpatient hospitalization

5 Multiple choice questions

  1. 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.
  2. mandates regulations that govern privacy, security, & electronic transactions standards for healthcare information.
  3. arranging appropriate healthcare services for discharged patients.
  4. 1940's
  5. network of physicians & hospitals that have joined together to contract w/insurance companies, employers.

5 True/False questions

  1. Managed Care Organizations (MCO):is responsible for the health of a group of enrollees & can be a health plan.


  2. Preauthorization:provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)


  3. Exclusive Provider Organization (EPO):contracted network of healthcare providers that provide care to subscribers for a discounted fee.


  4. HIPPA is to:provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.


  5. COBRA in 1985:provide better access to health insurance, limit fraud & abuse, & reduce administrative costs.