HBI Insurance Basics
If both parents have insurance from their employers, the insurance coverage of their
children is dependent on "The Birthday Rule". What does the Birthday Rule specifiy? -
✔️✔️the policy of the parent whose birthday comes first in the year is primary
Mr. McClure must pay a set amount of $1,000 of his healthcare costs before his
insurance coverage begins to cover any part of the costs. What type of patient liability is
he paying? - ✔️✔️Deductible
Which of the following insurance types requires the patient to have a PCP? -
✔️✔️HMO
Also known as the "policy holder," the ___________ is the originator of the insurance
policy while the _________ is a family member that is covered under the plan. -
✔️✔️subscriber; dependent
What is conisurance? - ✔️✔️The portion an insured patient owes after the deductible is
met
Indemnity health plans are also know as __________________. - ✔️✔️Fee-for-Service
Which of these is NOT a characteristic of a HMO? - ✔️✔️A referral from their PCP is
never required to see a specialist
Which of the following is NOT an example of a government insurance program? -
✔️✔️Indemnity
Which of the following is NOT one of the key steps in insurance verification? -
✔️✔️Check patient's medical hx
Failing to verify a patient's insurance can result in ________________. - ✔️✔️all of the
above: denial, patient dissatisfaction, authorization issues
The Non-Dependent or Dependent Rule states that if a patient is covered under two
plans-the subscriber for one and a dependent for the other-then the plan that is primary
and billed first is: - ✔️✔️the pan for which the patient is the subscriber
What is the correct term for an agency that contracts with an insruance company to
apply contracted discounts to billed charges on a claim? - ✔️✔️Repricer
If both parents have insurance from their employers, the insurance coverage of their
children is dependent on "The Birthday Rule". What does the Birthday Rule specifiy? -
✔️✔️the policy of the parent whose birthday comes first in the year is primary
Mr. McClure must pay a set amount of $1,000 of his healthcare costs before his
insurance coverage begins to cover any part of the costs. What type of patient liability is
he paying? - ✔️✔️Deductible
Which of the following insurance types requires the patient to have a PCP? -
✔️✔️HMO
Also known as the "policy holder," the ___________ is the originator of the insurance
policy while the _________ is a family member that is covered under the plan. -
✔️✔️subscriber; dependent
What is conisurance? - ✔️✔️The portion an insured patient owes after the deductible is
met
Indemnity health plans are also know as __________________. - ✔️✔️Fee-for-Service
Which of these is NOT a characteristic of a HMO? - ✔️✔️A referral from their PCP is
never required to see a specialist
Which of the following is NOT an example of a government insurance program? -
✔️✔️Indemnity
Which of the following is NOT one of the key steps in insurance verification? -
✔️✔️Check patient's medical hx
Failing to verify a patient's insurance can result in ________________. - ✔️✔️all of the
above: denial, patient dissatisfaction, authorization issues
The Non-Dependent or Dependent Rule states that if a patient is covered under two
plans-the subscriber for one and a dependent for the other-then the plan that is primary
and billed first is: - ✔️✔️the pan for which the patient is the subscriber
What is the correct term for an agency that contracts with an insruance company to
apply contracted discounts to billed charges on a claim? - ✔️✔️Repricer
