CPBS- CHAPTER 12

An indemnity plan is also referred to as _____________? A Fee-for-Service B Self-pay C Health Savings account D Preferred Provider Organization

A Fee-for-Service

Balance billing by participating providers is: A Necessary for maintaining a profitable practice B Not allowed under a participating provider's contract C Allowed only when the amount billed by the physician is greater than 20% of the contract amount. D Common practice among participating providers.

B Not allowed under a participating provider's contract

Carl has enrolled in a healthcare insurance plan that allows him to choose to have services provided within the Blue Cross/Blue Shield network or outside of the network. What type of plan best describes Carl's insurance coverage? A Indemnity B Point of Service C Health Maintenance Organization (HMO) D Preferred Provider Organization (PPO)

B Point of Service

The liaison between Blue Cross/Blue Shield and the contracted provider community is known as the: A Insurance Representative. B Provider Representative. C Provider Network Consultant. D All of the above.

D All of the above.

A savings account that allows individuals to save pre-tax dollars to reimburse for healthcare expenses is known as a(n): A Flexible Spending Account (FSA) B Health Savings Account (HSA) C Employer Savings Account (ESA) D Both a and b

D Both a and b

A health insurance plan that reimburses for healthcare services provided to members based on providers bills submitted after the services are rendered is known as: A traditional insurance. B fee-for-service. C indemnity. D all of the above.

D all of the above.

A patient's insurance member card is issued by: A the physician's office B the employer. C the state. D the insurance company

D the insurance company