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Test Bank For Understanding Health Insurance A Guide to Billing and Reimbursement - 2021 Edition - 16th - 2022 All Chapters - 9780357515587

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Test Bank For Understanding Health Insurance A Guide to Billing and Reimbursement - 2021 Edition - 16th - 2022 All Chapters - 9780357515587

Instelling
Vak

Voorbeeld van de inhoud

Test Bank for Health Insurance Today, 7th
p p p p p p




- 2021 All Chapters p p p p




A contract that provides compensation for specific losses resulting from illne
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ss or injury in exchange for a periodic payment is commonly referred to as: -
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ANSWER>>>health (medical) insurance
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Health insurance first began in the United States in Dallas, Texas, in: -
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ANSWER>>>1929

"Standard" health insurance, which provides comprehensive benefits and all
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ows individuals to see any doctor or use any hospital they choose, is common
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ly called: - ANSWER>>>indemnity insurance
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Most people who have health insurance today acquire it through: -
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ANSWER>>>state-subsidized entitlement programs
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A situation in which insured individuals pay a portion of their healthcare costs
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(deductibles and copayments) is called: - ANSWER>>>cost-sharing
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The concept that learning will not stop when individuals graduate from a c
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ollege or career program but that students will continue to learn for the re
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st of their lives is called: - ANSWER>>>lifelong learning
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The process of organizing daily responsibilities by the order of their importan
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ce is called : - ANSWER>>>prioritizing
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Self-discipline, possessing a positive attitude, and diligence are examples of :
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-
ANSWER>>>personal traits, qualities of character, and behavioral characteri
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stics

Writing down important facts from lectures and readings in your own words is
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called: - ANSWER>>>paraphrasing
p p

,Possessing the ability to work without direct supervision and the ability to
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make decisions without being subject to approval or undue influence from
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another person is called: - ANSWER>>>autonomy
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The growth of certain types of medical facilities has greatly increased the de
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mand for employees with a solid background in coding and excellent c -
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ANSWER>>>outpatient clinics and ambulatory care facilities
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The two basic types of health insurance are: -
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ANSWER>>>indemnity and managed care
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With an indemnity policy, patients: -
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ANSWER>>>may choose any provider they want, may change providers at a
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ny time, and pay a monthly premium
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The value of a provider' s service based on specific historical data is referred t
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o as: - ANSWER>>>the usual, customary, and reasonable (UCR)fee
p p p p p p p p




The universal form to submit claims to third-party payers is the : -
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ANSWER>>>CMS-1500
p




The kind of policy purchased by a self-
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employed individual or one who works for a company that does not offer
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a group policy is a/an: - ANSWER>>>individual policy
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The federal health insurance program that provides benefits to individuals 65
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or older and those under 65 with certain disabilities is called: -
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ANSWER>>>Medicare
p




The name of the federal entitlement program that covers certain categories o
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f low-income individuals and certain disabled people is called: -
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pANSWER>>>Medicaid

Insurance that pays workers who are injured or disabled on the job or who su
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ffer from job-related illnesses is called: - ANSWER>>>workers' compensation
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,The type of plan available to self-
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employed individuals that works in conjunction with special low-
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cost , high deductible health insurance is called a : -
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ANSWER>>>Medical Savings Account (MSA)
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The business of protecting, through legal means, a person or property against
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loss or harm is referred to as: - ANSWER>>>insurance
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Health insurance narrows down undesirable events to: -
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ANSWER>>>illnesses and injuries
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The federal healthcare program for the elderly and certain qualifying others i
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s - ANSWER>>>Medicare
p p




The combined federal and state healthcare program for indigent and low i
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ncome-income individuals is - ANSWER>>>Medicaid p p p p




Many employed individuals obtain healthcare coverage through a/an -
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ANSWER>>>group plan
p p




Fee-for-service healthcare plans are also referred to as -
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ANSWER>>>indemnity insurance
p p




In order to develop effective study skills, it is suggested that students g
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enerate a schedule - ANSWER>>>time management
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One method of enhancing one's career as a health insurance professional is t
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o acquire - ANSWER>>>Certification
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Career opportunities for a health insurance professional include -
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ANSWER>>>Physicians, healthcare organizations, and nursing homes
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The new version of HIPPA's standard for filing electronic claims is -
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ANSWER>>>5010
p

, The periodic fee for health insurance is commonly called a -
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ANSWER>>>Premium
p




The dollar amount that a patient must pay each year before his or her insuran
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ce benefits begin is called a/an - ANSWER>>>deductible
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Insurance companies often cap what a patient must pay, which is referred to a
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s the - ANSWER>>>out-of-pocket maximum
p p p p




The form that is most commonly used today for insurance claims submitted o
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n paper is the - ANSWER>>>CMS-1500
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Medical illnesses and injuries that a patient has prior to the purchase of a heal
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th insurance policy are called - ANSWER>>>Preexisting conditions
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A health insurance model intended to create a more organized and competiti
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ve market by offering consumers plan choices with common rules as to how t
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he plan is offered, its costs, etc., defines a/an -
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ANSWER>>>health insurance exchange
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According to HIPPA, which of the following code sets is acceptable for the e
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lectronic transmission of healthcare data - ANSWER>>>CPT-
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4 procedure codes
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Services or supplies that are appropriate and necessary for the symptoms, dia
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gnosis, and treatment of the medical condition and meet the standards of go
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od medical practice is the definition for - ANSWER>>>medical necessity
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Examples of technological advancements in enrollee verification include -
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pANSWER>>>interactive voice response systems, swipe terminals, and inte p p p p p p p


rnet-based eligibility check systems p p p




Medicare claims must be submitted electronically, unless the HHS secretary g
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rants a/an - ANSWER>>>waiver
p p p

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