Chapter 17 Flashcards
(10 cards)
A fixed dollar amount the subscriber must pay or meet each year before the insurer begins to cover expenses is?
deductible
Depending upon the type of plan the patients portion of the medical charges after the insurance has paid is known as the?
copayment or coinsurance
The national health insurance plan for Americans ages 65 and older is?
medicare
The appropriate definition for a Medicaid plan is?
health benefit plan
RBRVS consist of which components?
RVU, GAF, and CF
Why is it important that each procedure on CMS-1500 be matched with a diagnosis code?
proves medical necessity for the procedure
What is the most common method for medical practices to submit electronic medical claims to third party payers?
clearinghouse
What is the authorization called that directs an insurance carrier to pay the medical provider or the medical practice directly?
assignment of benefits
A managed care plan that establishes a network of providers to perform services for plan members is known as what?
PPO
The fixed dollar amount a subscriber must pay or meet each year before the insurer begins to cover expenses is?
deductible
