chapter 7 pt2

What is insurance?

• A government program that pays for healthcare costs for those in poverty

• Payment by contract by one party to another party in which the second party guarantees the first party against financial loss from a specific event

• The process used to track revenue from providing patient services

• A type of healthcare which focuses on reducing cost

Who is an insurer?

• A type of healthcare plan focusing on reducing costs

• A government or private organization that contracts with the healthcare consumer to pay either a portion or all medical expenses

• The individual responsible for paying the insurance premiums

• An entity that pays medical claims on behalf of the insured

What is managed care?

• Compensation received for providing healthcare services

• A type of healthcare which focuses on reducing cost and utilizing a primary care provider as a gatekeeper to care

• A government program for individuals over 65

• The translation of diagnoses and treatments into codes

What is medical coding?

• An amount paid monthly to continue insurance coverage

• A government program that pays for healthcare costs for those in poverty

• The translation of diagnoses and treatments into alphanumeric or numeric codes

• The process of obtaining approval from the insurer for a service before it is performed

What is Medicaid?

• A program that pays for healthcare for those over 65

• Compensation received for providing healthcare services

• Government program that pays for some or all of the healthcare costs for those in poverty

• The process used to track revenue from providing patient services

What is Medicare?

• The translation of diagnoses and treatments into codes

• Government program that pays for some or all of the healthcare costs for individuals over 65 and those with certain chronic health conditions

• An amount paid monthly to continue insurance coverage

• A type of healthcare which focuses on reducing cost

What is preauthorization?

• An entity that pays medical claims on behalf of the insured

• A government program that pays for healthcare costs for those in poverty

• The individual responsible for paying the insurance premiums

• The process of obtaining approval from the insurer for a service before the service is performed

What is a premium?

• Compensation received for providing healthcare services

• A government or private organization that contracts to pay medical expenses

• The process used to track revenue from providing patient services

• An amount paid by the insured to the insurance company, usually monthly to continue insurance coverage

What is reimbursement?

• Compensation received for providing healthcare services

• A type of healthcare which focuses on reducing cost

• The translation of diagnoses and treatments into codes

• A government program that pays for healthcare costs for those over 65

Who is a third-party payer?

• The process of obtaining approval from the insurer for a service before it is performed

• A government or private organization that contracts to pay medical expenses

• An entity that pays medical claims on behalf of the insured

• The individual responsible for paying the insurance premiums