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Medical Insurance Chapter 13th BlueCross BlueShield Questions and Answers well Explained Latest 2024/2025 Update 100% Correct. $7.99   Add to cart

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Medical Insurance Chapter 13th BlueCross BlueShield Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.

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BCBS indemnity coverage is characterized by certain limitations, including - hospital-only or comprehensive hospital and medical coverage One of the requirements that a participating provider must comply with is to - make fee adjustments for the difference between amounts charged to patients for...

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  • August 26, 2024
  • 4
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Medical Insurance Chapter 13th BlueCross BlueShiel
  • Medical Insurance Chapter 13th BlueCross BlueShiel
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ACADEMICMATERIALS
Medical Insurance Chapter 13th
BlueCross BlueShield
BCBS indemnity coverage is characterized by certain limitations, including - hospital-only or
comprehensive hospital and medical coverage



One of the requirements that a participating provider must comply with is to - make fee
adjustments for the difference between amounts charged to patients for services provided and payer-
approved fees.

Which is a program that requires providers to adhere to managed care provisions? - preferred
provider network (PPN)

One of the expectations that a nonparticipating provider has is to _____ for services rendered. -
obtain payment for the full fee charged

Which is considered a minimum benefit under BCBS basic coverage? - hospitalizations

Which is considered a service reimbursed by BCBS major medical coverage? - mental health visits

Which is a special clause in an insurance contract that stipulates additional coverage over and above the
standard contract? - riders

Prospective authorization or precertification is a requirement of the _____ BCBS managed care plan. -
outpatient pretreatment authorization

Which phrase is located on a Federal Employee Program plan ID card? - Government-Wide Service
Benefit Plan

The plan ID card for a subscriber who opts for BCBS's Health Care Anywhere PPO coverage uniquely
contains the _____ logo. - suitcase

Which Texas hospitalization plan began in 1929 and guaranteed 21 days of coverage per year? -
Blue Cross

In 1938, the Blue Shield plan originated to cover what type of fees? - physician services

Charitable, educational, civic, or humanitarian organizations whose profits are returned to the program
of the corporation rather than to shareholders are called: - nonprofit corporations

A for-profit corporation pays taxes on: - profits generated by the corporation's for-profit
enterprises

A member hospital is one that has signed a contract to: - provide services for special rates

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