Types of insurance plans
HMO stands for __________.
What is Health Maintenance Organizations
Active duty, retired, and Guard/Reserve members
What is sponsors
Identify the claim form you would use to send a paper claim.
What is CMS-1500
The __________ is the amount of money, paid by a policyholder or insured, before the insurance company pays on their claims.
What is deductible
FMAP is the abbreviation for
What is Federal Medicaid Assistance Percentage.
__________ is a national health insurance program that pays, or reimburses, for health care services provided to those over the age of 65.
What is Medicare
Individuals paying for services directly without insurance.
What is uninsured
What is self-pay
HIPAA EDI transactions must comply with
What is 5010A1 version.
The __________ is the amount of money, paid at each visit, by a policyholder or insured, to a provider.
What is copay
CHIP is the abbreviation for
What is Children's Health Insurance Program
__________ is a plan that pays for, or reimburses, medical assistance and health care services for people who are indigent.
What is Medicaid
The main individual who owns the policy, manages details, and is responsible for premiums.
What is the policyholder
Most third-party payers, including Medicare, prefer claim forms to be submitted __________.
What is electronically
Protects you from unexpected, high medical costs
What is health insurance
The federal government requires states to offer Medicaid benefits to children whose family income is under __________ percent of the poverty level.
What is 133%
__________ offers the most common health care plans you will encounter when caring for individuals in the military and their families.
What is Tricare
Individuals who are supported, either financially or with regard to insurance coverage, by others are known as __________.
What is dependents
__________is a health care claim form that is transmitted electronically.
What is 837
The __________ is the amount of money, often paid monthly, by a policyholder or insured, to an insurance company to obtain coverage.
What is insurance premium
TANF is the abbreviation for
What is Temporary Assistance for Needy Families
__________ is an insurance program designed to pay the medical costs for treating those injured, or made ill, at their place of work or by their job.
What is Workers’ Compensation
Individuals who qualify for both Medicare and Medicaid, often covered by a Dual Special Needs Plan (D-SNP)
What is dual eligible
The provider who provides the procedure on a claim other than the pay-to provider is called the
What is the rendering provider
__________ is a type of health insurance coverage that controls the care of each subscriber by using a primary care provider as a central health care supervisor.
What is HMO
What is managed care
Children under __________ years old who meet TANF requirements must be offered state Medicaid benefits.
What is 6 years old