American Culture
TX stands for
Texas
The place where individuals can shop for insurance plans
Health Insurance Marketplace
M.O.M stands for
Member out of the Middle
Differentiate In network from Out of network
In network - affiliated with Humana, Out of network - not affiliated with Humana
A specialty focused on high-quality care and person-centered care needed for adults
Geriatrics
The abbreviation for trafficway
TRFY
C.O.B.R.A stands for
Consolidated Omnibus Budget Reconciliation Act
A.E.R stands for
Acknowledge, Empathize, Reassure
Differentiate Co-insurance from Co-payment
Co-insurance: percentage, Co-payment: exact amount
DME stands for
Durable Medical Equipment
The are also known as the GI Generation
The Greatest Generation
Provide 3 Kinds of Preventive Care
Laboratory Test, Screening, Vaccines
P.E.T.A stands for
Permission, Explanation, Timeframe, Acknowledge
Differentiate Deductible from Premium
Deductible - amount to be satisfied for the insurance to kick in, Premium - amount to pay for the insurance
Differentiate Inpatient from Outpatient Procedures and provide one example for each.
Admission for more than 24 hours - Lung Surgery, Less that 24 hours stay at the hospital - Cataract Surgery
The 3 Common Fund Sources of Senior Citizen
Savings, Pension, Social Security
Differentiate the eligibility of Medicare, Medicaid, CHIP
65 and UP, End Stage; Low income individuals; Children up to 19
The 3 Factors that may affect your Delivery
Rate of Speech, Pitch, Energy
Explain the 4 Types of Enrollment
Initial Enrollment - 3 months before/after the member's 65th birthday, Annual Enrollment - October to December, Open Enrollment - January to March, Special Enrollment - qualifying life event
Provide 3 Laboratory Tests and explain its purpose
Blood Test, Pregnancy Test, Stool Test
The 4 Seasons in the USA including the months covered
Spring - March to May, Summer - June to August, Autumn - September to November, Winter - December to February
Differentiate Medicare Part A, B, C, and D
inpatient; inpatient, outpatient, DME; A&B, vision, dental, hearing; Drugs
Explain the 4 Types of Customer Profile
Thinker, Feeler, Entertainer, Controller
The Coordination of Benefits is
Coordination of Benefits: For members with 2 or more insurance plans
Provide 3 Radiological Services and explain its purpose
XRay, MRI, CT Scan