Exam 6: Traditional Fee For Service/Private Plans

The Affordable Care Act states that by 2014,everyone in the United States will be required to purchase a comprehensive set of healthcare benefits,which is referred to as:

Within these two broad categories,what are the four basic types of health insurance?

Blue Cross Blue Shield underwrites many different plan types;identify which of the following plan is not one of them:

Explain the BlueCard Program.

Fee-for-service plans offer the most choices of healthcare providers.

A set of government-regulated and standardized healthcare plans from which individuals may purchase health insurance eligible for federal funding are:

What is "self-insurance?"

In an FFS health plan,members typically pay a certain percentage of covered charges,called coinsurance.

Insurance companies are referred to as _____ payers.

Medicare supplemental insurance is intended to cover some costs that Medicare does not pay.

Blue Cross covers inpatient hospital expenses;Blue Shield applies to physician and other healthcare provider's services.

Blue Cross and Blue Shield policies are strictly fee-for-service plans.

Explain what Blue Cross and Blue Shield means by "timely filing."

________________ is designed specifically to provide coverage for some of the costs that Medicare does not pay,such as Medicare's deductible and coinsurance amounts.

One of the provisions of the Affordable Care Act was that most insurance plans must eliminate

A document prepared by the carrier that gives details of how a claim was adjudicated is called a/an:

When you see a suitcase emblem on a Blue Cross and Blue Shield card,it indicates that the patient is a government employee.

One kind of commercial insurance that the government does pay is the FEHB program,which is healthcare coverage for its own civilian employees.

Self-insured plans usually do not have to conform to traditional laws governing insurance,because they are technically not considered insurance companies.

Commercial carriers must furnish their own specific insurance claim form and cannot use the CMS-1500.