Chapter 13, Lesson 14: BlueCross BlueShield Questions
With Complete Solutions
_____ corporations are charitable, educational, civic, or
humanitarian organizations whose profits are returned to the
corporation rather than distributed to shareholders and officers
of the corporation. Because no profits of the organization are
distributed to shareholders, the government does not tax the
organization's income Correct Answers Nonprofit
_____ have not signed participating provider contracts, and they
expect to be paid the full fee charged for services rendered. In
these cases, the patient may be asked to pay the provider in full
and then be reimbursed by BCBS for the allowed fee for each
service, minus the patient's deductible and copayment
obligations. Even when the provider agrees to file the claim for
the patient, the insurance company sends the payment for the
claim directly to the patient and not to the provider Correct
Answers Nonparticipating providers (nonPARs)
_____ is a concept that allows members of independently owned
and operated BCBS plans to have access to health care benefits
throughout the United States and around the world, depending
on their home plan benefits. A blank suitcase logo on the
member's identification card indicates ______ coverage, such as
BlueCard® coverage (Figure 13-2). Generally, the
BlueCard®program enables such members obtaining health care
services while traveling or living in another BCBS plan's service
area (within the United States or in another country) to receive
the benefits of their home plan contract and to access local
, provider networks. As instructed by their home BCBS plan,
members call the phone number on their plan ID card to arrange
for pre-certification or prior authorization number, if necessary.
Correct Answers
______ includes international health care coverage for non-U.S.
based individuals and groups; this program covers individuals
who permanently reside outside the United States and provides
health care coverage during short-term and long-term travel
Correct Answers BlueCross BlueShield Global™
______ is a health care delivery system that provides health care
and controls costs through a network of physicians, hospitals,
and other health care providers. BCBS _______ plans include
the coordinated home health and hospice care program,
exclusive provider organizations, health maintenance
organizations, outpatient pretreatment authorization plans, point-
of-service plans, preferred provider organizations, and second
surgical opinions Correct Answers Managed care
______ is international health care coverage for employers,
individuals, and students who are based in the United States and
who are short-term travelers and long-term expatriates. Correct
Answers GeoBlue®
_______ corporations pay taxes on profits generated by the
corporation's enterprises and pay dividends to shareholders on
after-tax profits. Correct Answers For-profit
With Complete Solutions
_____ corporations are charitable, educational, civic, or
humanitarian organizations whose profits are returned to the
corporation rather than distributed to shareholders and officers
of the corporation. Because no profits of the organization are
distributed to shareholders, the government does not tax the
organization's income Correct Answers Nonprofit
_____ have not signed participating provider contracts, and they
expect to be paid the full fee charged for services rendered. In
these cases, the patient may be asked to pay the provider in full
and then be reimbursed by BCBS for the allowed fee for each
service, minus the patient's deductible and copayment
obligations. Even when the provider agrees to file the claim for
the patient, the insurance company sends the payment for the
claim directly to the patient and not to the provider Correct
Answers Nonparticipating providers (nonPARs)
_____ is a concept that allows members of independently owned
and operated BCBS plans to have access to health care benefits
throughout the United States and around the world, depending
on their home plan benefits. A blank suitcase logo on the
member's identification card indicates ______ coverage, such as
BlueCard® coverage (Figure 13-2). Generally, the
BlueCard®program enables such members obtaining health care
services while traveling or living in another BCBS plan's service
area (within the United States or in another country) to receive
the benefits of their home plan contract and to access local
, provider networks. As instructed by their home BCBS plan,
members call the phone number on their plan ID card to arrange
for pre-certification or prior authorization number, if necessary.
Correct Answers
______ includes international health care coverage for non-U.S.
based individuals and groups; this program covers individuals
who permanently reside outside the United States and provides
health care coverage during short-term and long-term travel
Correct Answers BlueCross BlueShield Global™
______ is a health care delivery system that provides health care
and controls costs through a network of physicians, hospitals,
and other health care providers. BCBS _______ plans include
the coordinated home health and hospice care program,
exclusive provider organizations, health maintenance
organizations, outpatient pretreatment authorization plans, point-
of-service plans, preferred provider organizations, and second
surgical opinions Correct Answers Managed care
______ is international health care coverage for employers,
individuals, and students who are based in the United States and
who are short-term travelers and long-term expatriates. Correct
Answers GeoBlue®
_______ corporations pay taxes on profits generated by the
corporation's enterprises and pay dividends to shareholders on
after-tax profits. Correct Answers For-profit
