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Study sets matching "health insurance"

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Study sets matching "health insurance"

31 terms
Health Insurance Study Notes
Medicare
Medicaid
Premium
Deductible
A federal system of health insurance for people over 65 years…
A federal system of health insurance for those requiring fina…
Amount regularly to purchase insurance coverage
Money you must pay yourself for health services before your h…
Medicare
A federal system of health insurance for people over 65 years…
Medicaid
A federal system of health insurance for those requiring fina…
17 terms
Group Health Insurance
Conversion Privilege
Coordination of Benefits Provision
Primary Insurance
Secondary Insurance
allows an employee to convert from a group policy to an indiv…
Eliminates the duplication of payments when an employee, spou…
insurance company that pays first, if the patient has more th…
This is the insurance company that is billed for any remainin…
Conversion Privilege
allows an employee to convert from a group policy to an indiv…
Coordination of Benefits Provision
Eliminates the duplication of payments when an employee, spou…
21 terms
Understanding Health Insurance Chapter 12
Commercial Health Insurance
Fee-for-service (or indemnity) insurance
High Risk Pools
Managed care
covers the medical expenses of individuals (e.g., private hea…
Traditional health insurance that covers a portion of service…
Last resort health insurance for individuals who cannot obtai…
Health maintenance organization, preferred provider organizat…
Commercial Health Insurance
covers the medical expenses of individuals (e.g., private hea…
Fee-for-service (or indemnity) insurance
Traditional health insurance that covers a portion of service…
15 terms
health insurance laws and social insurance
6 months
8 hour course... 4 hours every 2 year...c…
Asset disregard
50%
How long can an insurance company exclude a pre-existing cond…
whats the education requirement to sell long term care
Provision that protects long term care insureds assets... -insur…
what is the required minimum an insurer must pay in a long te…
6 months
How long can an insurance company exclude a pre-existing cond…
8 hour course... 4 hours every 2 year...c…
whats the education requirement to sell long term care
66 terms
UNDERSTANDING HEALTH INSURANCE CHAP 4
accept assignment
accounts receivable
accounts receivable aging report
accounts receivable management
provider accepts as payment in full whatever is paid on the c…
the amount owed to a business for services or goods provided.
shows the status (by date) of outstanding claims from each pa…
assists providers in the collection of appropriate reimbursem…
accept assignment
provider accepts as payment in full whatever is paid on the c…
accounts receivable
the amount owed to a business for services or goods provided.
13 terms
Health Occ - Health Insurance
Health Care Insurance
Deductables
Co-insurance
Co-payment
system to pay for healthcare
amount that must be paid by patient before the system starts…
requires that specific percent-ages of expenses are shared by…
a specific payment of money the patient for a health care ser…
Health Care Insurance
system to pay for healthcare
Deductables
amount that must be paid by patient before the system starts…
36 terms
UNDERSTANDING HEALTH INSURANCE CHAP 14
advance beneficiary notice of noncover…
benefit period (Medicare)
conditional primary payer status
coordinated care plan
document that acknowledges patient responsibility for payment…
begins with the first day of hospitalization and ends when th…
Medicare claim process that includes the following circumstan…
also called managed care plan; includes health maintenance or…
advance beneficiary notice of noncover…
document that acknowledges patient responsibility for payment…
benefit period (Medicare)
begins with the first day of hospitalization and ends when th…
80 terms
Health Insurance Licensing
Blackout Period
Misstatement of Age or Sex Provision
Change of Occupation Provision
Fraud
Social Security pays a benefit to a surviving spouse left to…
If the insured's age or sex is misstated in an application fo…
This provision is found in health insurance stating if the in…
An act of deceit; concealment or misrepresentation of materia…
Blackout Period
Social Security pays a benefit to a surviving spouse left to…
Misstatement of Age or Sex Provision
If the insured's age or sex is misstated in an application fo…
61 terms
Health Insurance Glossary of Terms
account number
accounts receivable
adjudication:
advance beneficiary notice
the number a patient is given by the doctor or hospital which…
the total amount of money owed for professional services prov…
the final determination of the issues involving settlement of…
an agreement given to the patient to read and sign before pro…
account number
the number a patient is given by the doctor or hospital which…
accounts receivable
the total amount of money owed for professional services prov…
61 terms
Types of Health Insurance
Health Insurance
Disability Insurance
Accidental Injury
Sickeness
covers economic losses due to the perils of accidental injury…
Also known as accident and health (A&H) and accident and sick…
is generally defined as accidental bodily injury (i.e., andy…
is usually a defined as illness and disease that first manife…
Health Insurance
covers economic losses due to the perils of accidental injury…
Disability Insurance
Also known as accident and health (A&H) and accident and sick…
10 terms
Health Insurance Study Set
health insurance policy
premium
deductible
co-payment
contract between an insurance company and an individual; can…
amount of money an insurance policy holder pays monthly to pu…
amount of money a person pays for health care expenses before…
amount paid by insured person for each health care service e.…
health insurance policy
contract between an insurance company and an individual; can…
premium
amount of money an insurance policy holder pays monthly to pu…
16 terms
MAS Health Insurance Review
policy holder
premium
insured
provider
person in whose name the policy is written
the rate charged for an insurance policy
the person who is covered by an insurance policy
health care professional who supplies the health care to the…
policy holder
person in whose name the policy is written
premium
the rate charged for an insurance policy
12 terms
Chapter 35 - Life and Health Insurance
life insurance
proceeds
beneficiary
cash-value insurance
Insurance that is paid to a person or people designated to re…
The value of an insurance policy (life insurance).
A survivor who receives part or all of the proceeds.
This type of permanent insurance provides both savings and de…
life insurance
Insurance that is paid to a person or people designated to re…
proceeds
The value of an insurance policy (life insurance).
10 terms
Health insurence
Alternative
Aspect
Concern=worry
Emphasize=stress
(adj)xen kẽ,thay phiên
(n)bề ngoài, diện mạo
(n,v)liên quan, dính líu ;lo lắng, quan tâm
(v)nhấn mạnh,làm nổi bật
Alternative
(adj)xen kẽ,thay phiên
Aspect
(n)bề ngoài, diện mạo
100 terms
Health Insurance General Knowledge
Five Renewability Provisions
Participating vs. Non Participating He…
Types of claims payments
Blue Cross vs Blue Shield
1. Non-cancelable - as long as you pay premium, they cannot c…
Participating - Chance to receive dividends... Non-participating…
-Contracts of reimbursement... -Indemnity/valued contracts: spec…
Blue Cross = hospital coverage... Blue Shield = doctor and medic…
Five Renewability Provisions
1. Non-cancelable - as long as you pay premium, they cannot c…
Participating vs. Non Participating He…
Participating - Chance to receive dividends... Non-participating…
15 terms
Health Insurance Policy Terms
Benefit Period
Coinsurance
Coordination of Benefits
Copayment
Length of time a health insurance policy will pay benefits. A…
Cost sharing in which the policy or policy holder pays a pre-…
Coordinating payments from all health insurance sources to en…
Cost sharing measure in which the policy or certificate holde…
Benefit Period
Length of time a health insurance policy will pay benefits. A…
Coinsurance
Cost sharing in which the policy or policy holder pays a pre-…
25 terms
Health Systems and Insurance
medicare
medicaid
HMO
PPO
insurance coverage for those individuals over the age of 65
insurance coverage for individuals with a low income.
health maintenance organization focus is to prevent illness a…
preferred provider organization individuals get to choose a d…
medicare
insurance coverage for those individuals over the age of 65
medicaid
insurance coverage for individuals with a low income.
62 terms
UNDERSTANDING HEALTH INSURANCE CHAP 9
All-Patient diagnosis-related group (A…
All-Patient Refined diagnosis-related…
allowable charge
ambulance fee schedule
DRG system adapted for use by third-party payers to reimburse…
adopted by Medicare in 2008 to reimburse hospitals for inpati…
maximum fee a provider may charge.
payment system for ambulance services provided to Medicare be…
All-Patient diagnosis-related group (A…
DRG system adapted for use by third-party payers to reimburse…
All-Patient Refined diagnosis-related…
adopted by Medicare in 2008 to reimburse hospitals for inpati…
12 terms
Health insurances
Deductible
Co-insurance
Co-payment
Prefered provider organization
Amounts hat must be paid by patients for medical services bef…
Require specific percentages of expenses are shared buy the p…
specific amount of money a patient pays form a particular ser…
forms a contract with certain health care agencies and provid…
Deductible
Amounts hat must be paid by patients for medical services bef…
Co-insurance
Require specific percentages of expenses are shared buy the p…
10 terms
Health insurances
Medicare
Anthem/ Blue Cross
Most work comps
Aetna
In network
In network
In network
In network
Medicare
In network
Anthem/ Blue Cross
In network
16 terms
Health Insurance Terminology
Deductible
Premium
Co-Insurance
Co-Pay
The amount the insured must pay on a claim before the insuran…
The amount the insured (or often the employer) must pay month…
The percentage the insured must pay on a claim once the deduc…
A set fee paid at the time of service in exchange for care. F…
Deductible
The amount the insured must pay on a claim before the insuran…
Premium
The amount the insured (or often the employer) must pay month…
Insurance - Health Insurance Provisions/Clauses/Riders
Uniform Individual Accident and Sickne…
Health insurance Policy, signed applic…
7 days for weekly premium... 10 days for…
When the beneficiary is designated as…
This has been adopted in all states and established standard…
What constitutes the entire contract for Health insurance?
How long is the grace period in Health Insurance? (for weekly…
When can the policyowner not change the beneficiary at any ti…
Uniform Individual Accident and Sickne…
This has been adopted in all states and established standard…
Health insurance Policy, signed applic…
What constitutes the entire contract for Health insurance?
47 terms
Health Insurance Chapter 2
ASCA
HIPAA
Blue Cross
Base Period
Administrative Simplification Compliance Act; establishes a s…
1996 mandates and governs the privacy, security, and electron…
B/C; Insurance plan created in 1929 to cover hospitalization…
A period of time from which weekly disability benefits are ca…
ASCA
Administrative Simplification Compliance Act; establishes a s…
HIPAA
1996 mandates and governs the privacy, security, and electron…
98 terms
1: Accident and Health Insurance
Basic Hospital Expense Policies
Basic Surgical Expense Policies
Comprehensive Major Medical Expense Po…
Supplement Major Medical
First dollar coverage with no deductible that pays for hospit…
Covers only the surgical services of a physician performed in…
Benefits for catastrophic injury or sickness and often supple…
provides both first-dollar coverage offered by "Basic Plan" a…
Basic Hospital Expense Policies
First dollar coverage with no deductible that pays for hospit…
Basic Surgical Expense Policies
Covers only the surgical services of a physician performed in…
28 terms
Accident and Health Insurance Basics
All of the following statements about…
In order to comply with Fair Credit Re…
A specified policy would cover which o…
An applicant purchased a disability po…
The contents of an inspection report cannot be disclosed to t…
At the time of application
Cancer
Contingent beneficiary
All of the following statements about…
The contents of an inspection report cannot be disclosed to t…
In order to comply with Fair Credit Re…
At the time of application
52 terms
Health and health insurance
Opt
Portion
Percentage
Refer
Lựa chọn
Tỉ lệ,phần
Tỉ lệ phần trăm
Nhắc đến
Opt
Lựa chọn
Portion
Tỉ lệ,phần
22 terms
Health Insurance and Disability Income Insurance
Partial Disability
Individual Mandate
Discrimination
Cancelable Policy
the inability of the insured to perform one or more important…
a portion of the recently passed health reform legislation th…
a term that refers to how the insurance industry differentiat…
policy that gives the insurer the right to refuse to renew th…
Partial Disability
the inability of the insured to perform one or more important…
Individual Mandate
a portion of the recently passed health reform legislation th…
436 terms
Insurance - Wisconsin Health and Life
Accident
Accident Insurance
Accidental Bodily Injury
Accidental Death and Dismemberment
An unplanned, unforeseen event which occurs suddenly and at a…
A type of insurance that protects the insured against loss du…
Unplanned, unforeseen traumatic injury to the body.
An insurance policy which pays a specified amount or a specif…
Accident
An unplanned, unforeseen event which occurs suddenly and at a…
Accident Insurance
A type of insurance that protects the insured against loss du…
23 terms
Health Care Insurance Terms
Insurance
Premium
Co-Pay
Deductible
Coverage provided for Health Care
Monthly fee for amount/type of coverage
Fee for office visits and medications
Fee amount to be met before coverage begins
Insurance
Coverage provided for Health Care
Premium
Monthly fee for amount/type of coverage
16 terms
Health Insurance Vocabulary
Universal Health Insurance
Co-Payment
Medicare
Medicaid
Health care systems that are aimed at allowing all citizens a…
A flat fee that you pay every time you receive a covered serv…
A federal program of health insurance for persons 65 years of…
A federal system of health insurance for those requiring fina…
Universal Health Insurance
Health care systems that are aimed at allowing all citizens a…
Co-Payment
A flat fee that you pay every time you receive a covered serv…
16 terms
Basic Health Insurance
birthday rule
10-digit code to identify physician's…
Tricare and CHAMPVA cover
Submitting claims electronically
the insurance policy of the policyholder whose birthday comes…
National Provider Identifier
military families and personnel
helps the office save time and money
birthday rule
the insurance policy of the policyholder whose birthday comes…
10-digit code to identify physician's…
National Provider Identifier
35 terms
Health Insurance Vocabulary
Acute care
Authorization
Benefit
Claim
Medical care that you need right away but only for a short time
The process of getting approval from your insurance company b…
A service covered by your health insurance
A request to your health plan to pay a bill for a health care…
Acute care
Medical care that you need right away but only for a short time
Authorization
The process of getting approval from your insurance company b…
10 terms
Health Insurance Vocabulary
Health care system
preventive care
primary care physician
specialist
all the medical care available to a nation's people, the way…
keeping disease or injury from happening or getting worse
the medical doctors who provide physical checkups and general…
doctors trained to handle particular kinds of patients or med…
Health care system
all the medical care available to a nation's people, the way…
preventive care
keeping disease or injury from happening or getting worse
12 terms
Lesson 48: Health Insurance
alternative
aspect
concern
emphasize
(a) allowing a choic; other 替代的、二選一的
(n) a feature element; an appearance 觀點、外表
(v) anxiety; worry 不安、擔心、影響
(v) to stress 強調、加強
alternative
(a) allowing a choic; other 替代的、二選一的
aspect
(n) a feature element; an appearance 觀點、外表
171 terms
Life, Accident, Health & Disability Insurance
Insurance
Insurance Interest
Foreign Insurance Company
Renewable Term Insurance
Transfers risk of loss from the insured to the company
Financial interest in having the life of the insured continued
An insurance company that is incorporated outside the state w…
Term insurance where the insured has the option of continuing…
Insurance
Transfers risk of loss from the insured to the company
Insurance Interest
Financial interest in having the life of the insured continued
15 terms
Unit Health Insurance
Coinsurance
Copayment
Deductible
Exclusions
The portion of covered medical expenses you must pay after me…
A fixed fee paid by the patient at the time of an office visit.
Specified amount of money that the insured must pay for cover…
Specific hazards listed in an insurance policy for which the…
Coinsurance
The portion of covered medical expenses you must pay after me…
Copayment
A fixed fee paid by the patient at the time of an office visit.
Health Insurance - Terms
AD&D
After care
COBRA
Co-Pay
Accidental death and dismemberment insurance
the care, follow-up treatment or therapy needed by a patient…
a federal law that requires an employer to extend health insu…
a set fee paid by the policyholder for medical expenses upon…
AD&D
Accidental death and dismemberment insurance
After care
the care, follow-up treatment or therapy needed by a patient…
18 terms
Health Insurance Terms
deductible
co-payment
coinsurance
member
The portion of health care costs that the insured must first…
a specific dollar amount the patient must pay each visit
a percentage that the patient pays for services
enrollee
deductible
The portion of health care costs that the insured must first…
co-payment
a specific dollar amount the patient must pay each visit
14 terms
Health Insurance Vocabulary Terms
premium
deductible
co-payment (co-pay)
out-of-pocket
the amount paid to an insurance agency for a health insurance…
the amount that must be paid by the patient before the insura…
an amount paid by the patient for a certain services
a medical bill that must be paid by the patient
premium
the amount paid to an insurance agency for a health insurance…
deductible
the amount that must be paid by the patient before the insura…
20 terms
Health Insurance Plans, Prin. of Health Science
Health Insurance policy
Premium
Deductible
Co-Payment
A contract between an insurance company and an individual or…
The amount the policy- holder or his/her employer pays to the…
The amount a person must pay for health care expenses before…
The amount that the insured person must pay out of pocket for…
Health Insurance policy
A contract between an insurance company and an individual or…
Premium
The amount the policy- holder or his/her employer pays to the…
48 terms
health insurance concepts
adhesion
Cobra
Conditional receipt
claims experience rating
makes insurance provisions in favor of the insured due to the…
- Provision... -Requires the employer to offer coverage to a ter…
insured gives premium along with application ... insurer gives w…
premium renewal for group insurance are based on
adhesion
makes insurance provisions in favor of the insured due to the…
Cobra
- Provision... -Requires the employer to offer coverage to a ter…
12 terms
Health Insurance Terms
Worker's Compensation
TRICARE
Medicaid
Deductible
Health insurance plan providing treatment for workers injured…
U.S. Government health insurance plan for all military person…
Medical assistance program that is jointly funded by the fede…
Amounts that must be paid by the patient for medical services…
Worker's Compensation
Health insurance plan providing treatment for workers injured…
TRICARE
U.S. Government health insurance plan for all military person…
41 terms
health insurence
each time a pt comes to the clinic, th…
which of the following is the purpose…
health insurance was designed for what…
which of the following terms means an…
D
A
B
B) co insurance
each time a pt comes to the clinic, th…
D
which of the following is the purpose…
A
24 terms
Principles of Health Science Insurance Vocabulary
Health insurance policy
Premium
Deductible
Co-payment
a contract between an insurance company and an individual or…
amount the policy-holder or his/her employer pays to the heal…
amount a person must pay for health care expenses before insu…
amount the insured person must pay out of pocket for services…
Health insurance policy
a contract between an insurance company and an individual or…
Premium
amount the policy-holder or his/her employer pays to the heal…
20 terms
Health Insurance Review
Number of Americans without Health Ins…
Insurance Claim
Patient
Provider
33 million
formal request to the insurance company for reimbursement for…
One who receives care
Physician or supplier who provides medical care or supplies
Number of Americans without Health Ins…
33 million
Insurance Claim
formal request to the insurance company for reimbursement for…
47 terms
Health Insurance Chapter 2
ASCA
HIPAA
Blue Cross
Base Period
Administrative Simplification Compliance Act; establishes a s…
Health Insurance Portability and Accountability Act; 1996 man…
B/C; Insurance plan created in 1929 to cover hospitalization…
A period of time from which weekly disability benefits are ca…
ASCA
Administrative Simplification Compliance Act; establishes a s…
HIPAA
Health Insurance Portability and Accountability Act; 1996 man…
8 terms
health insurance terms
HMO
PPO
deductible
premium
A prepaid health insurance plan in which patients receive hea…
More Options for providers but costs more.
amount you have to pay before insurance kicks in
amount taken out of paycheck per month for insurance
HMO
A prepaid health insurance plan in which patients receive hea…
PPO
More Options for providers but costs more.
12 terms
Lesson 48: Health Insurance
allow
alternative
aspect
concern
ยินยอม, ปล่อย, ยอม... verb., to let do or happen; to permit
ซึ่งไม่เป็นไปตามแผนเดิม, ที่มีตัวเลือก... adjective., allowing a…
ลักษณะ, รูปลักษณ์... noun., a feature element; an appearance
ความกังวล... noun., anxiety; worry
allow
ยินยอม, ปล่อย, ยอม... verb., to let do or happen; to permit
alternative
ซึ่งไม่เป็นไปตามแผนเดิม, ที่มีตัวเลือก... adjective., allowing a…
10 terms
Health Care and Health Insurance
Obamacare
Health economics
Characteristics of health care
Principle-agent problem with physician
Patient protection and affordable care act, individual and bu…
The behavior of economic agents (buyers,... sellers, third parti…
- Uncertainty in both the necessity and effectiveness of trea…
- The patient (principle) wants the physician to act in their…
Obamacare
Patient protection and affordable care act, individual and bu…
Health economics
The behavior of economic agents (buyers,... sellers, third parti…
21 terms
Health Insurance and Health Organizations
premium
copay
deductible
Managed care
is what is paid to have a policy
is the amount you pay every time you use the plan
is the flat fee paid to use the service before the policy beg…
requires companies to provide quality care at the lowest poss…
premium
is what is paid to have a policy
copay
is the amount you pay every time you use the plan
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