Kinn's The Administrative Medical Assistant - Chapter 16 Basics of Health Insurance

Kinn's The Administrative Medical Assistant - Chapter 16 Basics of Health Insurance The amount payable by an insurance company for a monetary loss to an individual insured by that company, under each coverage, is known as _________. - ANSWER-benefits In the United States, healthcare practitioners render services ______________ receiving payment. - ANSWER-prior to Active duty military personnel, family members, military retirees and their eligible family members under the age of 65, and the survivors of all uniformed services are covered by ___________. - ANSWER-TRICARE The health benefits program run by the Department of Veterans Affairs (VA) that helps eligible beneficiaries pay the cost of specific healthcare services and supplies is the (give acronym)________________. - ANSWER-CHAMPVA ___________________ provides periodic payments to replace income when an insured person is unable to work as a result of illness, injury, or disease. - ANSWER-Disability Income Insurance An alphanumeric number issued by the insurance company giving approval of a procedure or service is a(n) ___________. - ANSWERauthorization code The ___________________ is the date on which the insurance coverage begins so that benefits are payable. - ANSWER-Effective date ___________________________ is the process of confirming health insurance coverage for the patient for the medical service and the date of service. - ANSWER-Verification of Eligibility The term for limitations on an insurance contract for which benefits are not payable is __________________. - ANSWER-exclusions A reimbursement model in which the health plan pays the provider's fee for every health insurance claim is called ________________. - ANSWER-Fee-for-service or Indemnity plan An insurance term used when a primary care provider wants to send a patient to a specialist is ______________. - ANSWER-referral The fee schedule designed to provide national uniform payment of Medicare benefits after adjustment to reflect the differences in practice costs across geographic areas is called the _______________________________. - ANSWER-Resource-Based Relative Value Scale (RBRVS) A(n) ______________ is funded by an organization with an employee base large enough to fund its own insurance plan. - ANSWER-Self-funded plan The intermediary and administrator who coordinates patients and providers and processes claims for self-funded plans is called a(n) ________________. - ANSWER-Third-party administrator A government-sponsored program under which authorized dependents of military personnel receive medical care was originally called CHAMPUS but now is called ____________________. - ANSWERTRICARE Medicaid and Medicare are examples of ________________ plans. - ANSWER-Government-sponsored A privately sponsored health plan purchased by an employer for their employees is considered a(n) ____________________ policy. - ANSWER-Employer-sponsored group