5 Written questions
5 Matching questions
- Pre-admission review:
- SOAP stands for:
- Managed Care Organizations (MCO):
- Current Procedural Terminology (CPT) is developed:
- Clinical Laboratory Improvement Act (CLIA):
- a review for medical necessity of inpatient care prior to admission
- b is responsible for the health of a group of enrollees & can be a health plan.
- c by American Medical Association in 1966
- d 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.
- e S-Subjective
5 Multiple choice questions
- grants prior approval for reimbursement of a healthcare service
- 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.
- amount for which the patient is financially responsible before insurance policy provides coverage
- responsible for providing healthcare services to subscribers in a given geographical area for a fixed fee.
- network of physicians & hospitals that have joined together to contract w/insurance companies, employers.
5 True/False questions
Integrated Delivery System (IDS): → organization of affiliated providers' sites that offer joint healthcare services to subscribers
Utilization review: → method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case
Coinsurance: → 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
What year First Blue Cross policy started: → 1939
Health Maintenance Organization came in effect in → 1973