Exam 3: Basics of Health Insurance

Match each type of health plan to its description. -A contract that insures a person against on-the-job injury or illness.

Match each type of health plan to its description. -Government-sponsored program that provides hospital and medical services for dependents of active duty uniform service members, military retirees and their families, and survivors of uniformed services.

For Medicaid cases, there is no assignment of benefits unless the patient has other insurance in addition to Medicaid.

The act created to protect workers and their families so that they can get and maintain health insurance if they change or lose their jobs is called the

The first legal item in the business of handling medical insurance is the insurance ____________________ or policy.

The efficient medical insurance specialist usually groups together all outstanding charges of patients who have the same type of insurance and processes these insurance claims at the same time.

Basic health insurance coverage includes benefits for skilled nursing facilities.

Discovering the maximum dollar amount that the carrier will pay for a procedure is called ____________________.

The Patient Protection and Affordable Care Act (PPACA) will make health care available and affordable to Americans who are currently without insurance coverage.

The five classifications of health insurance policies are (1) cancelable, (2) optionally renewable, (3) conditionally renewable, (4) guaranteed renewable, and (5) ____________________.

If a child has health insurance coverage from two parents, according to the birthday law

If Mary Smith goes to Dr. Baker's office and Dr. Baker gives Mary Smith professional services that she accepts, this is an expressed contract.

An insurance claims representative also may be known as the claims adjudicator.

Match each type of health plan to its description. -The hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

The person who is applying for insurance coverage is called the ____________________.

Most legal issues of private health insurance claims fall under

Match each type of health plan to its description. -An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

The concept of managed care began in the 1930s when Montgomery Ward and Company offered it to their employees.

In a managed care plan, the participating provider is also referred to as: ___________________________

An emancipated minor is