Health Insurance
Medical Terminology
Word Parts
Managed Care
Utilization Review/Management
100

Patients 65 and over may have _______ insurance.

Medicare

100

Foundation of the medical term is referred to as the?

Word Root

100

Dermat/o means?

Skin

100

Type of managed care plan that is composed of both PPO and HMO benefits?

Point of Service Plans (POS)

100

Techniques and policies for evaluating the necessity of medical treatments and services on a case-to-case basis is known as?

Utilization Management

200

When we go see our medical provider for a sick visit we may have a ________ with our health insurance.

co-pay

200

“a,” “e,” “i,” or “u.” are examples of?

combining vowels

200

Stomat/o means?

Mouth

200

Health Maintenance Organizations (HMO's) allow patients to see out of network providers?

True or False

False

200

Method used to match the patient’s clinical picture and care interventions to evidence-based criteria is referred to as?

Utilization Review

300
Employees who have health insurance through their employer may pay a monthly ____________ for their health insurance coverage.
premium
300

Medical terms that do not use word parts to compose them. are known as?

Nondecodeable Terms

300

-logy means?

Study of

300

These managed care plans may have annual deductibles and out of pocket expenses patients may have to meet before the insurance will pay for medical services?

Preferred Provider Organizations (PPOs)

300

Utilization reviews were initially performed by?

RNs

400

If a patient has insurance that covers 90/10, 80/20, 50/50 the percentage the patient pays contributes to their _______________________?

Out of Pocket Expense

400

Medical terms that are shortened for ease are referred to as?

abbreviations

400

-itis means?

inflammation

400

If I have an HMO insurance plan and need to see a specialist I may need to obtain a?

Referral

400

Which type of review occurs before treatments start?

Prospective Review

500

A patient may have to pay a __________ first before the health insurance will cover medical services.

Deductible

500

TURP and CABG are examples of?

Acronyms

500

Phlebitis means?

Inflammation of the vein

500

I have a POS insurance plan and have a consultation scheduled with a Gastroenterologist and need a referral.

True or False

False

500

Which type of review analyzes effectiveness and medical necessity of the treatment and/or procedure performed?

Retrospective Review