Health Insurance CH:2 (Intro to Health
Insurance)
Ambulatory Payment Classifications (APCs) - Answer Prospective payment system
used to calculate reimbursement for outpatient care according to similar clinical
characteristics and in terms of resources required.
Balanced Budget Act of 1997 (BBA) - Answer Addresses health care fraud and abuse
issues, and provides for Department of Health and Human Services (DHHS) Office of
the Inspector General (OIG) investigative and audit services in health care fraud cases
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
- Answer Program that provides health benefits for dependents of veterans rates as 100
percent permanently and totally disabled as a result of service-connected conditions,
and veterans who died on duty with less than 30 days of active service
Civilian Health and Medical Program-Uniformed Services (CHAMPUS) - Answer
Originally designed as a benefit for dependants of personnel serving in the armed
forces and uniformed branches of the Public Health Service and the National Oceanic
and Atmospheric Administration; now called TRICARE
Clinical Labarotory Improvement Act (CLIA) - Answer Established quality standards for
all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test
results regardless of where the test was performed.
CMS-1500 - Answer Form used to submit Medicare claims; previously called the HCFA-
1500
Coinsurance - Answer Also called coinsurance payment; the percentage the patient
pays for covered services after the deductible has been met and the copayment has
been paid
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) - Answer Allows
employees to continue health care coverage beyond the benefit termination date
Consumer-Driven Health Plan (CDHP) - Answer Health care plan that encourages
individuals to locate the best health care at the lowest possible price, with the goal of
holding down costs; also called consumer-directed health plan
Continuity of Care - Answer Documenting patient care services so that others who treat
the patient have a source of information on which to base additional care and treatment
Insurance)
Ambulatory Payment Classifications (APCs) - Answer Prospective payment system
used to calculate reimbursement for outpatient care according to similar clinical
characteristics and in terms of resources required.
Balanced Budget Act of 1997 (BBA) - Answer Addresses health care fraud and abuse
issues, and provides for Department of Health and Human Services (DHHS) Office of
the Inspector General (OIG) investigative and audit services in health care fraud cases
Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
- Answer Program that provides health benefits for dependents of veterans rates as 100
percent permanently and totally disabled as a result of service-connected conditions,
and veterans who died on duty with less than 30 days of active service
Civilian Health and Medical Program-Uniformed Services (CHAMPUS) - Answer
Originally designed as a benefit for dependants of personnel serving in the armed
forces and uniformed branches of the Public Health Service and the National Oceanic
and Atmospheric Administration; now called TRICARE
Clinical Labarotory Improvement Act (CLIA) - Answer Established quality standards for
all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test
results regardless of where the test was performed.
CMS-1500 - Answer Form used to submit Medicare claims; previously called the HCFA-
1500
Coinsurance - Answer Also called coinsurance payment; the percentage the patient
pays for covered services after the deductible has been met and the copayment has
been paid
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) - Answer Allows
employees to continue health care coverage beyond the benefit termination date
Consumer-Driven Health Plan (CDHP) - Answer Health care plan that encourages
individuals to locate the best health care at the lowest possible price, with the goal of
holding down costs; also called consumer-directed health plan
Continuity of Care - Answer Documenting patient care services so that others who treat
the patient have a source of information on which to base additional care and treatment
