Basics of Health Insurance C-tec

What is a beneficiary?

• Spouse

• A recipient of health insurance benefits

• Insurance Provider

• Physician

Medicaid is administered by

• State governments

• Federal governments

• Private Company

• Non Pro-Fit

A patient comes in with a piece of metal shavings in his eye that he got while welding at his job. He has Anthem health insurance through his work. Which of the following insurances would cover his visit?

• Medicaid

• Anthem

• Workers Compensation

• Disability Insurance

The difference between an HMO and a PPO is

• HMO cost less but a better provider

• PPO plans allow patients to be seen out of network at an increased cost, while HMOs do not

• HMO plans allow patients to be seen out of network at an increased cost, while PPOs do not

• There is no difference between HMOs and PPOs

The time allowed to submit a claim to Medicare is

• 365 days

• 180 days

• 120 days

• 90 days

An alphanumeric number issued by the insurance company giving approval of a procedure or service is a

• Preauthorization

• Authorization

• Waiting Period

• Subscriber

The amount payable by an insurance company for a monetary loss to an individual insured by that company, under each coverage, is known as

• Premiums

• Medicare Supplement

• Benefits

• Disability

Patients covered by an employer ssponsored group health insurance plan typically share the cost of

• Dental Care

• Premiums

• Long Term Health Insurance

• Benefit Plans

What is utilization management?

• A group policy offered to full time employees

• A process of managing health care costs by influencing patient care decision.

• Health insurance contract to tailor the needs of each individual

• Coverage that pays for all or part of your hospitalization

A fee for service is

• Co Pay

• A reimbursement model in which the health plan pays for all provider fees.

• Paying for insurance premiums

• Deductible