Chapter 1 review questions medical billing
In the United States, the birth of health insurance occurred in
1929
Congress passed the Health Maintenance Organization Act in
1973
Identify the act that allows employees to continue their group insurance coverage at group rates for up to 18 months when they quit their job, are laid off, or their hours are reduced.
COBRA
What act did HIPAA amend that provided new rights and protections for participants and beneficiaries in group health plans?
ERISA
Identify the act that Congress introduced that (among other things) required most employer-sponsored group health insurance plans to accept transfers from other group plans without imposing a preexisting condition clause.
HIPAA
____ is when there is a written agreement between two parties whereby one entity promises to pay a specific sum of money to a second entity if certain specified undesirable events occur to the second party.
Insurance
The combined federal and state healthcare program for indigent and low-income individuals is
Medicaid
Two common state health insurance programs for the uninsured are
Medicaid and CHIP
The federal healthcare program for the elderly and certain qualifying others is
Medicare
Identify which of the following is not one of the basic types of health insurance plans:
Medicare. The two basic types of insurance plans are indemnity and managed care plans.
Two of the groups exempted from the Affordable Healthcare Act mandate are
Native Americans/incarcerated individuals
One of the new healthcare laws enacted in 2010 that brought major changes to how Americans can get access to healthcare more easily is the
Patient Protection and Affordable Care Act (PPACA)
Which of the following is not a reason of increasing healthcare costs?
Population movement from rural to urban areas. Reasons for increase in healthcare costs: Advances in medical technology Rise in chronic diseases Media intervention
When an individual is required to pay a portion of the healthcare costs, such as deductibles, coinsurance, or copayment amounts, it is referred to as
cost-sharing
Many employed individuals obtain healthcare coverage through a(n)
group plan
Medical (or health) insurance narrows down "undesirable events" to ____ and _____.
illness and injury
Health insurance narrows down undesirable events to
illnesses and injuries
How much Americans pay for health insurance and whether they qualify for subsidies depends on their
income
Factors listed in the text that drive healthcare issues include all of the following except
increasing genetic testing. Includes: regulating managed care plans, expanding access for uninsured Americans, and stabilizing emergency services
The business of protecting, through legal means, a person or property against loss or harm is referred to as
insurance
The law now makes it illegal for any health insurance plan to use ____ to exclude, limit, or set unrealistic rates on coverage for adults.
preexisting conditions
The money a business entity or individual pays and insurance company for protection from loss or harm is called a
premium
The cost-saving practice of keeping people well or catching an emerging illness early when it is more treatable is referred to as
preventive medicine
Securitas is the Latin term for
security
The two forms that insurance companies must issue to applicants that explain the plan's benefits and coverage are
summary of benefits of coverage (SBC)/ glossary of insurance terms
