Catergory 1
Catergory 2
Catergory 3
Catergory 4
Catergory 5
100
The amount of $ paid to keep an insurance policy in force is called?
Premium
100
Veterans of the U.S Armed Forces may be covered by ?
CHAMPVA
100
A policy that covers numerous people under a single master contract, and is no self-funded is called a ______ policy?
Group
100
Medical insurance provided to employees funded by the organization itself rather than a third party insurance company is called __________ coverage
Self-Insured
100
Federal & State sponsored Health insurance program for the medically indigents is called __________.
Medicaid
200
Health care designed for military families and military personel is called?
Tricare
200
What type of insurance provides coverage for especially large medical bills resulting from prolonged illness?
Major Medical Insurance
200
The amount of money that the policyholder pays before the insurance company will pay on a claim is known as the __________.
deductible
200
Limited access to specialized care and referrals is a disadvantage of __________ plans
Managed Care
200
A document that explains what expenses were paid after submission to medicare is called __________.
EOB - Explanation of Benefits
300
A type of insurance that protects workers from loss of wages after an industrial accident that happened on the job is called __________.
Workmens Compensation
300
Insurance that protects a person in the event of a certain type of accident such as an automobile or plane crash is called __________.
Special Risk Insurance
300
The individual entitled to receive benefits from an insurance policy or program is called the __________.
beneficiary
300
The periodic payment for insurance coverage is called the __________.
Premium
300
The amounts payable by an insurance company for a monetary loss to an insured individual are called __________.
Benefits
400
Entities that make a payment on a debt, but were not the party who created the debt are called __________.
Third Party Payers
400
A review of cases by a committee to ensure that services are medically necessary is called __________.
Utilization Review
400
A physician who enters a contract with an insurance company is called a __________.
Participating Provider
400
“Medicare Part D” is known as the __________ plan of Medicare Which part of Medicare covers physician office visits
1- Prescription 2- Part B
400
recipient of AFDC (age 37) is eligible for Medicare. True or False
False
500
Describe an Independent Practice Association HMO Model
A group of physicians who practice in their own offices who formly organize into a group
500
A payment method in which providers are paid for each enrolled individual plan whether or not services were performed is called a __________ plan
Capitation
500
A provision attached to an insurance policy to expand or limit coverage is called a __________.
Rider
500
When a provider obtains permission from a carrier to perform specific procedures it is called __________.
pre- authorization
500
If Samantha has a $1,000 deductible, and a $100 surgery copay, how much will insurance pay on her bill of $6,784.00?
$5,684.00
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