Medical Office Management C Flashcards
A bed patient in a hospital is called a (n) ________-
A. inpatient
B. outpatient
C. third party payer
D. provider
A. Inpatient
A person who represents either party of an insurance claim is the ______
A. doctor
B. adjuster
C. provider
D. subscriber
B. Adjuster.
A request for payment under an insurance contractor bond is called a (n) _______
A. insurance application
B. claim
C. dual choice request
D. total disability
B. Claim
Payment made periodically to keep an insurance policy in force is called ________
A. time limit
B. premium
C. coinsurance
D. fee-for-service
B. Premium
A person or institution that gives medical care is a (n) _________
A. third parter payer
B. provider
C. adjuster
D. insurance agent
B. Provider
Which of the following insurance plans provides a fixed payment per month to the physician regardless of the services rendered?
A. capitation
B. preferred provider
C. adjuster
D. insurance agent
A. Capitation
An amount the insured must pay before policy benefits begin is called ______
A. indemnity
B. extended benefits
C. deductible
D. catastrophic
C. Deductible
An organization that offers health insurance at a fixed monthly premium with little or no deductible and works through primary care provider is called a (n) ___________
A. preferred provider
B. health maintenance organization
C. member physician
D. private health provider
B. Health maintenance organization
Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called ___________
A. catastrophic
B. severe
C. third-party payer
D. no correct answer
A. Catastrophic
A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient is called a (n) ___________
A. inpatient
B. outpatient
C. carrier
D. adjuster
B. Outpatient
An injury that prevents a worker from performing one or more of the regular functions of his job would be known as a _____________
A. partial disability
B. permanent disability
C. total disability
D. resultant disability
A. Partial disability
A previous injury, disease or physical condition that existed before the health insurance policy was issued is called __________
A. preexisting condition
B. prior exposure
C. foregoing condition
D. no correct answer
A. Pre-existing condition
one who belongs to a group insurance paln is called ___________
A. third -party payer
B. subscriber
C. carrier
D. no correct answer
B. subscriber
A sum of money provided in an insurance policy, payable for covered services is called ___________.
A. deductible
B. benefits
C. dues payable
D. premium
B. benefits
To prevent the insured from receiving a duplicate payment for losses under more then one insurance policy is called _______________
A. fee-for-service
B. hospital benefits
C. coordination of benefits
D. non duplication benefits
C. Coordination of benefits.
When a patient has health insurance, the percentage of covered services that is responsibility of the patient to pay is known as ___________
A. coinsurance
B. pre-defined policy
C. comprehensive
D. in percent policy
A. Coinsurance
Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called __________
A. primary insurance
B. major medical
C. whole life policy
D. comprehensive
B. Major medical
An unexpected event which may cause injury is called ____________
A. dread disease rider
B. accident
C. adjuster
D. no correct answer
B. Accident
A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called ___________
A. subscriber
B. claim representative
C. participating physician
D. adjuster
C. Participating physician
Insurance plans that pay a physician’s full charge if it does not exceed his normal charge or does not exceed the amount normally charged for the service is called ______________
A. usual, customary and reasonable
B. comprehensive
C. dual choice
D. no correct answer
A. Usual, customary and reasonable
