Kinns Chapter 20

The TRICARE option that is similar to a preferred provider network is TRICARE:

Extra

Which of the following is not an advantage of managed care:

Access to specialized care & referrals is limited

Which of the following is a type of insurance verification method:

Asking about the patient's insurance during the initial appointment telephone call, copy the insurance card when the patient arrives for an appointment, calling the carrier to verify benefits and eligibility (All of the above)

Veterans of the U.S. Armed Forces may be covered by what insurance:

CHAMPVA

A payment method in which providers are paid for each enrolled individual in a plan whether or not he or she sees the provider that month is called a what plan:

Capitation

The amount of money that the policyholder pays per claim or per accident toward the total amount of an insured loss before the company will pay on the claim is known as what:

Deductible

Health insurance benefits are determined by:

Indemnity schedules, service benefits plans, relative value studies (All of the above)

Which type of HMO model consists of physician with separately owned practices who formally organize into a group but continue to practice in their own office:

Independent practice association

The federal and state sponsored health insurance program for the medically indigent is called:

Medicaid

Which of the following expenses would be paid by Medicare part B:

Outpatient hospital care, durable medical equipment, physician services, other medical services. (All of the above)

The physician who enters into a contract with an insurance company and agrees to certain rules and regulations is called a:

Participating provider

A document that explains what expenses were paid after submission to Medicare and sent to the physician's office is called what:

Remittance Advice

Which the of referral is usually processed immediately:

STAT

Health insurance designed for military dependents and military personnel is called:

Tricare

A policy that covers a number of people under a single master contract issued to the employer or to an association with which they are affiliated and that is not self-funded is usually called what:

Group Policy