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Flashcards in Medical Office Management - C Deck (50)
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1

A bed patient in a hospital is called a(n) _______.

inpatient

2

A person who represents either party of an insurance claim is the _______.

adjuster

3

A request for payment under an insurance contractor bond is called a(n) _______.

claim

4

Payment made periodically to keep an insurance policy in force is called _______.

premium

5

A person or institution that gives medical care is a(n) _______.

provider

6

Which of the following insurance plans provides a fixed payment per month to the physician, regardless of the services rendered?

capitation

7

An amount the insured must pay before policy benefits begin is called _________.

deductible

8

An organization the offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider is called a(n) ______.

health maintenance organization

9

Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called _______.

catastrophic

10

A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient is called a(n) _____.

outpatient

11

An injury that prevents a worker from performing one or more of the regular functions of his job would be known as a _______.

partial disability

12

A previous injury, disease or physical condition that existed before the health insurance policy was issued is called ________.

preexisting condition

13

One who belongs to a group insurance plan is called ______.

subscriber

14

A sum of money provided in an insurance policy, payable for covered services is called _______.

benefits

15

To prevent the insured from receiving a duplicate for losses under more than one insurance policy is called ________.

coordination of benefits

16

When a patient has health insurance, the percentage of covered services that is the responsibility of the patient to pay is known as _______.

coinsurance

17

Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called ________.

major medical

18

An unexpected event which may cause injury is called _______.

accident

19

A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called ________.

participating physician

20

Insurance plans that pay a physician's full charge if it does not exceed the amount normally charged for the service is called _________.

usual, customary and reasonable

21

A notice of insurance claim or proof of loss must be filed within a designated _______ or it can be denied.

time limit

22

A health program for people age 65 and older under social security is called _______.

medicare

23

A civilian health and medical program of the uniform services is called _______.

Tri-Care

24

A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment is called ________.

workers' compensation

25

A recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of payment on a claim is called ________.

explanation of benefits

26

A type of insurance whereby the insured pay a specific amount per unit of service and the insurer pays the rest of the cost is called ________.

co-payment

27

In insurance, greater coverage of diseases or an accident, and greater indemnity payment in comparison with a limited clause is called _______.

comprehensive

28

A rider added to a policy to provide additional benefits for certain conditions is called ______.

dread disease rider

29

An interval after a payment is due to the insurance company in which the policy holder may make payments, and still policy remains in effect is called ______.

grace period

30

An agreement by which a patient assigns to another party the right to receive payment from a third party for the service the patient has received is called _______.

assignment of benefits