Key Insurance Terms
This is the total amount a member must pay upfront for services BEFORE the insurance begins to pay.
What is Deductible
This plan typically has lower premiums, requires a member to see their PCP before attempting to get any other kind of medical care, requires a referral to see a specialist, and does not cover out of network services.
What is HMO (Health Maintenance Organization)
Rightway is headquartered here?
What is New York City
Which year was the last for Blockbuster Video?
What is 2014.
What does out of Pocket Maximum mean?
What is: The total amount a member will be responsible to pay for the entire plan year
Once the Out of Pocket Maximum is met all of member claims are covered at 100%
This plan has typically higher premiums, and more flexibility, does not require a referral to see a specialist, has added flexibility that lets a member see OON providers.
What is PPO (Preferred Provider Organization)
Navigation has two main locations - what are they?
What is Miami and Denver.
How many keys are on the standard piano
What is 88
What is the difference between In-Network and Out of Network?
What is:
INN Providers or health care facilities that are part of a health plan's network of providers with which it has negotiated a discount.
OON
Providers or health care facilities that do not have a contract with the member’s insurance plan.
This will most likely result in higher prices.
Some health plans will not cover care from out-of-network providers at all, except in certain emergency situations.
What is the big difference between a PPO (Preferred Provider Organization) and a EPO (Exclusive Provider Organization)
What is EPO is a PPO plan with NO Out of Network Options.
What year was Rightway Founded?
What is 2017
What is the national fruit of the United States?
What is Oranges
This is the term used for the amount that an INN provider agrees to accept as reimbursement for a service.
What is Allowable Amount (also known as negotiated or contracted rate)
This plan is a PPO where you are required to pay for all services upfront until you meet the deductible which is generally over 2k. Once the deductible is met, the member will pay Co-Insurance and will be paying discounted In Network Prices.
What is HDHP (High Deductible Health Plan)
What is something the company is focusing on in 2023? (From the Executive Presentation)
What is/are Growth, Gross Margin, Activation, Churn, Member Satisfaction, Employee Engagement.
Name all four books in the Twilight Series?
What is Twilight, New Moon, Eclipse and Breaking Dawn.
What is Balance Billing?
The difference between the billed and the allowed amount For an OON claim the member is fully responsible for the Balance Bill
ie. A procedure costs $10K - The Allowable Amount is $3K - The Balance Bill is $7K
This insurance plan has not network. Members can seek care anywhere they choose but not all providers are willing to work with this plan. This plan pays providers a percentage of established benchmark pricing - these members are usually balanced billed.
What is RBP (Reference Based Pricing)
Pay close attention to what is actually being covered with these plans.
What is one of Rightway's Values?
What is/are:
Redefine what is possible.
Debate then commit,
We cultivate Grit,
We are human First,
We Seek to Delight.
Who is the most decorated Olympian of all time?
Who is Michael Phelps. (28 Olympic Medals)