Term
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Definition
| insurance purchased in the early 1900s to provide income replacement in the event of illness |
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Term
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Definition
| insurance providing income to a policyholder who is disabled and cannot work |
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Term
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Definition
| a contract between the subscriber and the insurance company to pay for medical care and preventive services |
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Term
| health insurance identification card |
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Definition
| card given to subscriber as proof of insurance |
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Term
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Definition
| a patient with no health insurance who must pay out of pocket for medical care |
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Term
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Definition
| the insurance plan that is billed first for medical services |
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Term
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Definition
| the insurance plan that is billed after the primary has paid or denied payment |
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Term
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Definition
| another name for secondary insurance |
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Term
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Definition
| secondary insurance that picks up the patient's deductible and/or co-insurance |
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Term
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Definition
| supplemental insurance for patients with Medicare as their primary, which pick up the deductible and co-insurance |
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Term
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Definition
| the physician has signed a contract with the insurance company |
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Term
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Definition
| If a claim is denied by a patient's primary insurance, where is it sent? |
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Term
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Definition
| A patient has insurance through an employer and is also covered through a spouse's employer. Which insurance is primary, the patient's or the patient's spouse's? |
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Term
False
You need to make a copy of both sides |
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Definition
| T or F: It is important to make a copy of the back side of a patient's insurance card |
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Term
False
An insurance company can have several addresses |
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Definition
| T or F: If two patients have health insurance with the same company, then the claims of both will go to the same address |
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Term
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Definition
| the number listed on the identification card that identifies the patient to the insurance company |
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Term
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Definition
| the number on the identification card that identifies the patient's employer group health plan |
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Term
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Definition
| a specific name assigned by the insurance company designating a specific plan for that type of insurance. |
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Term
| policyholder, subscriber, insured |
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Definition
| three terms that mean the person who has the health insurance (carries it) |
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Term
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Definition
| term used for a patient who has Medicare coverage |
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Term
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Definition
| a flat fee the patient pays each time for medical services that is associated with managed care plans |
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Term
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Definition
| a percentage the patient is responsible to pay of the cost of medical services--associated with indemnity, traditional, and commercial health insurance plans |
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Term
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Definition
| the amount the patient is responsible to pay before any reimbursement is issued by the insurance company--usually associated with indemnity, traditional, and commercial plans |
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Term
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Definition
| a type of insurance plan in which reimbursement is made at 80 percent of the allowed amount, and the patient pays the remaining 20 percent |
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Term
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Definition
| T or F: Monies are only paid after the patient's deductible has been met |
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Term
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Definition
| The 20% in an indemnity plan is called the __________. |
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Term
| Centers for Medicare and Medicaid Services |
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Definition
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Term
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Definition
| What two types of plans are part of CMS? |
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Term
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Definition
| T or F: Medicare and Medicaid are government plans |
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Term
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Definition
| the dollar amount an insurance company deems fair for a specific service or procedure |
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