Medical Insurance Chapter 13th BlueCross BlueShiel
Medical Insurance Chapter 13th BlueCross BlueShiel
Exam (elaborations)
Medical Insurance Chapter 13th BlueCross BlueShield Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.
1 view 0 purchase
Course
Medical Insurance Chapter 13th BlueCross BlueShiel
Institution
Medical Insurance Chapter 13th BlueCross BlueShiel
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...
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
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ACADEMICMATERIALS. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.