Health Insurance: Chapter 6 (Underwriting) - Test Cram Session

Which of the following involves analyzing a case before admission to determine what type of treatment is necessary?

Prospective Review

P is self-employed and owns an Individual Disability Income policy. He becomes totally disabled on June 1 and receives $2,000 a month for the next 10 months. How much of this income is subject to federal income tax?

$0 - b/c Disability Income benefits that derive from an individual policy was already paid entirely by the policyowner and NOT subject to FEDERAL INCOME TAX.

Any changes made on an insurance application requires the initials of whom?

the APPLICANT

Which of the following BEST describes how pre-admission certifications are used?

to prevent nonessential medical costs

Pre-hospitalization authorization is considered an example of:

Managed Care

Which type of plan normally includes hospice benefits?

Managed Care Plans

An underwriter determines that an applicant's risk should be recategorized due to a health issue. This policy may be issued with a(n)

Exclusion for the Medical Condition

retrospective review

The part of the utilization review process that concentrates on a review of clinical information following patient discharge