BCBS TEST QUESTIONS & ANSWERS SOLVED 100% CORRECT.

BCBS TEST QUESTIONS & ANSWERS SOLVED 100% CORRECT. Which plan is primary? When a patient is covered by her employer-sponsored group plan and by a government plan (not affiliated with the employer). Employer-sponsored plan Which plan is primary? When a patient is covered by her employer's group insurance plan and also, covered by her spouse's group plan. Employer-sponsored plan For treatment not covered by the insurance plan requires prospective authorization, otherwise known as ...? Precertification 101, 102, 103 and 104 are the four Federal enrollment options and considered what ID number on BCBS Claims? Group ID number Blue Cross and Blue Shield plans originated as two separate entities selling what type of health plans? Pre-paid Medical Where did the first Blue Shield plan originate? Palo Alto, California What are special contract clauses that stipulate additional coverage for health care services? Riders Most BCBS plans policyholders are known as? Members What is the deadline for submitting, customarily? One year from date of service What clause always coverage for immediate treatment sought and received for sudden, severe, and unexpected conditions that, if left untreated, would place the patient's health in jeopardy? Medical Emergency Care Rider Hospitalization, laboratory services, x-ray services, surgical fees, assistant surgeon fees, obstetric care, intensive care, newborn care and chemotherapy are routine service covered by? BCBS What year did the American Hospital Association (AHA) become the approving agency for accreditation of new prepaid hospitalization plans? 1939 What year did Blue Cross and Blue Shield merge into a single corporation called BlueCross BlueShield Association? 1986 What year did Blue Cross and Blue Shield combine personnel under the leadership of a single president, responsible to both boards of directors? 1977