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Health Administration & Professional Responsibility > Insurance > Flashcards

Insurance Flashcards

1
Q

What are the 4 types of insurance in athletic training?

A

Primary
Secondary
Liability
Catastrophic

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2
Q

What are the 4 Types of “Managed care plans”?

A

HMO
PPO
POS
EPO

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3
Q

What is “HMO”?

A

Prepaid contact between insurance company and provider.

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4
Q

What is “PPO”?

A

INS negotiated reduced rates with providers and cost more for the patient.

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5
Q

What is “POS”?

A

Allows patient to seek care outside of HMO for higher copayment.

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6
Q

What is “EPO”?

A

Provider have contract with insurance company, employer, and other entity.

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7
Q

What does “HMO” stand for?

A

Health Maintenance Organization

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8
Q

What does “PPO” stand for?

A

Preferred Provider Organization

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9
Q

What does “POS” stand for?

A

Point of Service

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10
Q

What does “EPO” stand for?

A

Exclusive Provider Organization

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11
Q

What is “Medicare”?

A

INS for people 65 years old and up

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12
Q

What is “Medicaid”?

A

INS for low income

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13
Q

What are “CPT Codes”?

A

Documenting procedures in medical records.

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14
Q

What does “CPT” stand for?

A

Current Procedural Terminology

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15
Q

What is the “International Classification of Disease”?

A

International comparability of mortality statistics.

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16
Q

What is “UB-92”

A

Universal billing codes

17
Q

What is “Advanced Beneficary Notice”?

A

Medicare document of provider

18
Q

What is “Explantation of Benefits form”?

A

Wont be reimbursed with out it

19
Q

What managed care program provides a set fee per member?

A

Capitation

20
Q

A contractual obligation of one party to compensate the loss incurred to the other party due to the acts of the indemnitor or any other party.

A

Indemnity

21
Q

Broadest sense is a natural person or other legal entity who receives money or other benefits from a benefactor.

A

Beneficary

22
Q

What other name identifies a traditional indemnity insurance plan?

A

Fee-for-service

23
Q

What health care organization defined services to enrolled patients for a specific sum of money during a specific time period.

A

HMO

24
Q

Who is considered the “gatekeeper” of managed health care systems?

A

Primary Care physician

25
Q

Who comprises the joint venture for Medicaid benefits?

A

Federal and state government

26
Q

What are CPT and ICD codes?

A

Reimbursement codes

27
Q

What management style did Mary Parker Follet propose?

A

Coorperation and democracy in the workplace

28
Q

What team of health care workers are contracted to deliver health care to a specific population?

A

PPO

29
Q

What reimbursement code do all health care workers use to describe the patients condition?

A

ICD 10 codes

30
Q

What are CPT codes?

A

Billing codes

Health Administration & Professional Responsibility (9 decks)

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