Exam 17: Insurance Billing

The ________ is the annual payment made to an insurance company by the patient to keep the insurance policy in effect.

Patients who belong to a managed care health plan, such as an HMO, are responsible for a small per-visit fee collected at the time of the visit. This fee is commonly called a(n) ____.

A husband and wife are both employed and have work-sponsored insurance plans that cover each other and their three children. Which insurance plan is the primary payer?

The person whose name the insurance is carried under is called the ____.

Eligibility for Medicaid is ____.

In a typical medical practice, insurance claims are filed ____.

Of the federal programs providing healthcare, the largest is ____, which provides health insurance for citizens aged 65 and older.

What percent of the allowable fee does Medicare pay the healthcare provider after the annual deductible is met?

A small fee that is collected at the time of service is called a(n) _______.

The ________ is a fixed amount that must be paid by the policyholder each year before a third-party payer begins to cover medical expenses.

Which of the following is correct regarding electronic claim submissions?

The payment system used by Medicare is based on ____.

Legal clauses in insurance policies that prevent duplication of payment are called ________ of benefits clauses.

A(n) "________" healthcare claim is one that is error-free and is accepted for processing by the payer.

The payment system used by ________ is called the resource-based relative value scale (RBRVS).

Federal law requires employers to purchase and maintain a certain minimum amount of workers' ________ insurance for their employees.

The process of deciding the amount of money that will be paid by a third-party payer for a procedure is ____.

One advantage of submitting claims electronically is ____.

Which of the following is not part of the process for verifying workers' compensation coverage?

A(n) ________ procedure is a medical procedure that is not required to sustain life and that is planned in advance to be done at the convenience of the physician or surgeon and the patient.