Exam 3: Basics of Health Insurance

Match each type of health plan to its description. -A medical capitation plan in which the treatment is delivered via a clinic or independent physician that provides a number of basic medical services for a fixed capitation payment per month.

The insured may not necessarily be the patient seen for the medical service.

Information such as the deductible, copayment, preapproval provisions, and insurance company address and telephone number can usually be found on the insurance card.

The reason for a coordination of benefits statement in a health insurance policy is

A patient intake sheet is also called a

A two- or three-part form that incorporates a combination bill, insurance form, and routing document used in both computer- and paper-based systems is called an encounter form.

Health Benefit Exchanges will make the process of researching, comparing, and purchasing health insurance policies more difficult.

Match each type of health plan to its description. -A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease.

A coordination of benefits statement in an insurance policy refers to the waiting period.

If an insurance policy states that pregnancy is not covered, the policy would list it as a/an ____________________.

A state and federal program for children who are younger than 21 years of age and have special health care needs is

The Supreme Court deemed the Affordable Care Act's requirement to require individuals to have health insurance coverage or face a penalty as unconstitutional.

The contract in a workers' compensation case exists between

The federal government can assess penalties for not collecting coinsurance for patients seen under the ________________ program.

Private insurance companies with whom the provider does not have a contractual agreement will send the check to the patient regardless of whether the patient has signed an assignment of benefits.

Mr. Talili has two medical insurance policies. To prevent duplication of payment for the same medical expense, the policies include a

When a payment is received, it is posted and ____________________ to the patient's account on the ledger card and current daysheet.

A policy in which the insurer cannot increase premium rates and must renew the policy until the insured reaches the age specified in the contract is a

When a contract is not manifested by direct words but is deduced from the circumstance, the general language, or the conduct of the patient, it is referred to as a/an ____________________ contract.

Many Health Insurance Claim Forms contain a/an ______________________________ that directs the insurance company to pay benefits directly to the provider of care on whose charge the claim is based.