WorksheetsHealth Insurance Basics Review
Total questions: 47
Worksheet time: 30mins
The amount you must pay on a claim before the insurance company will pay.
Premium
Policy
Loss
Deductible
A payment made monthly, twice a year, or yearly, for an insurance policy.
Premium
Copay
Tax
Benefit
The amount of money an insurance policy holder must pay on a claim before the insurance company begins to pay. The higher this is, will usually result in a lower premium.
Premium
Claim
Deductible
Policy
A set dollar amount you agree to pay each time you receive medical treatment, while the insurance company agrees to cover the rest
Copay
Claim
Premium
Deductable
Insurance and patient share the cost of medical procedures based on a percentage
co-payment
premium
deductible
co-insurance
______________ insurance provides financial protection against overwhelming medical expenses
Health
Car
Comprehensive
Medical
A(n) _________ is the amount of money you must pay each year before your insurance company starts paying
life
beneficiary
deductible
health
_______________ requires you to pay either a set amount or a certain percent of medical expenses
co-insurance
co-payment
life term
term life
A(n) ____________ is a predetermined flat fee you pay for health care services
co-insurance
whole life
co-payment
term
The percentage a patient pays for services after the deductible has been met is called:
co-payment
deductible.
fee for service.
coinsurance.
Methods used to verify patient coverage include:
telephone.
point-of-service device.
plan website.
All of the above
same thing.
Does the insurance company pay for ALL medical expenses as long as you pay your monthly premium?
Yes
No
A fixed amount you pay for a covered health care service, usually when you get the service.
Deductible
Copay
Premium
The amount you owe for health care services each year before the insurance company begins to pay
Coinsurance
Deductible
Copay
The amount an insured must pay against a claim after the deductible is satisfied.
Coinsurance
Deductible
Copay
______________ insurance provides financial protection against overwhelming medical expenses
Health
Car
Comprehensive
Medical
How much you have to spend before your insurance pays anything is called the:
Premium
Deductible
Copayment or coinsurance
Out-of-pocket maximum
A health care professional, hospital, or pharmacy that is part of a health plan’s list of preferred providers. You will generally pay less for services received from these providers because they have negotiated a discount for their services in exchange for the insurance company sending more patients their way.
Network Providers
Primary Care Providers
Non-Network Providers
Provider
A facility, physician, nurse practitioner, who provides, coordinates or helps a patient access a range of health care services.
Network Providers
Primary Care Providers
Non-Network Providers
Provider
A facility or provider who does not contract with your insurance company or who does not participate in your health care plan.
Network Providers
Primary Care Providers
Non-Network Providers
Provider
A physician who serves as the insured's first point of contact within the health plan. This provider gives basic medical services, coordinates and, if required by the plan, authorizes referrals to specialists and hospitals.
Network Providers
Primary Care Providers
Non-Network Providers
Provider
A physician, health care professional or health care facility licensed, certified or accredited as required by state law to render or provider medical services.
Network Providers
Primary Care Providers
Non-Network Providers
Provider
5 digit code for reporting and billing purposes
Diagnosis Code
Medical Code
Procedure Code
Computer Code
3-7 characters used for reporting and billing purposes used to identify the problem or condition of the patient.
Diagnosis Code
Medical Code
Procedure Code
Computer Code
5 digit code used to represent a service provided to the patient for medical reporting and billing purposes
Diagnosis Code
Medical Code
Procedure Code
Computer Code
