Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Member Services Abbreviations > CCG & Terminology Trainer > Flashcards

CCG & Terminology Trainer Flashcards

1
Q

MOOP

What is the definition

A

Maximum out of pocket
The maximum dollar amount an insured can be responsible for and covered products or services in a set time period usually a plan year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

OOP

What do the letters stand for

A

Out-of-pocket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

OOP

What is the definition

A

Out of pocket

If the plan has a deductible, the subscriber pays 100% out of pocket until it is satisfied.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MOOP

What do the letters stand for

A

Maximum out-of-pocket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Subscribe

A

The primary cardholder who is enrolled for single or family coverage and whose dependence may also be eligible for benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Copayment

A

A specific flat rate dollar amount that the member must pay each time they get a prescription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Co- insurance

A

A preset Dollar amount the member pays prior to receiving the full benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Benefit or plan year

A

The 12 month. And then the plan would start over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

EOB

What do the letters stand for?

A

Explanation of benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

EOB

What is the definition

A

Exclamation of benefits

Documentation explaining how the benefit was administered for service and products rendered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TPA

What do the letters stand for?

A

Third-party administrator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TPA

What is the definition?

A

Third-party billing
Third party administrator managers that administration of the benefit for an employer or health plan Navitus is not a TPA this is only for dental vision and health care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CPI

What do the letters stand for?

A

Pharmaceutical care incentive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CPI

What is the definition?

A

Pharmaceutical care incentive

It is a incentive program that will reimbursed pharmacist for part of the time they spend counseling patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ACA

What do the letters stand for?

A

Affordable care act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ACA

What does this mean?

A

The affordable care act
means it is a requirement to cover some contraceptives at a zero co-pay. There are some exceptions the grandfathered versus the non-grandfathered in relations to the affordable healthcare

17
Q

Grandfathered versus non-grandfathered in relation to the health care reform what does this mean?

This one is for grandfathered

A

Grandfathering,
In relation to healthcare reform means that the client chooses to maintain the benefit they held prior to January 1 of 2013 affordable care act changes that require coverage of certain contraceptive products at a zero co-pay.

18
Q

Grandfathered versus non-grandfathered in the relation to healthcare reform

This one is non-grandfathered

A

Non-grandfathered means that they will be covered at zero co-pay

Member Services Abbreviations (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions