FBLA STUDY GUIDE FOR 2025/2026 (QUESTIONS WITH
100% CORRECT ANSWERS)
FUTA - Allows collection of taxes in order to fund state programs
Adjudicate - Settles payment on insurance claims. Also refers to review of evidence in a trial
Latent - Incubation period. Infections are persistent and go into relapse
JCHAO - Reviews and accredits hospitals
NCQA - Reviews and accredits health plans
ASC - Ambulatory services center. Line by line billing allows for less costs
Adverse selection - Attracting patients that are sicker than usual
Admission Certification - Admitting patients that need more care
Single Payer System - Government Run. Care Triad (Cost, quality, access)
Evidence Based Medicine - Uses EMR of patient to determine the best treatment
National Labor Relations Act - Allows hospital/heath care providers to use bargaining units
Fair Labor Standards Act of 1938 - Establishes Minimum Wage, Ages, overtime pay for workers
Equal Pay Act - Pay equality amongst genders
HEDIS - Compares health plan performance
OASIS - Reimbursement for home health care plans
, UHDDS - Uniform health discharge data set. Needed for Medicare reporting
OSHA - Establishes and regulates workplace safety
Protected Health Information - Records of a patient's past and present health condition, how the
care was provided and how the patient paid
HIPPA - Health Information Privacy and Portability act
Provisions of HIPPA - Cannot be denied coverage for group insurance, coverage wait cannot exceed
12-18 months, safeguards electronc information, privacy of health records
Copay - Payment defined by policy that grants access to the treatment
Premiums - Money paid to insurers to negate the risk of loss. Lower payments result in high
treatment costs
HMO - Health Maintenance Organization: Individuals pay a fixed amount and get access to facilities
within the plan
PPO - Typical insurance style. Individuals pay a fee for service along with copay and deductables
through a network of providers
POS - Similar to a HMO, but with extentions through payment similar to a PPO plan
HDHP - Insurance plan for high risk individuals. Low premium but has high deductables
Medicare - Health care plan entitled to people 65 and older
Medicaid - Health care plan granted by states to low income individuals
ERISA - Act that allows employers to set up insurance plans. Also allows funding for Medicaid
100% CORRECT ANSWERS)
FUTA - Allows collection of taxes in order to fund state programs
Adjudicate - Settles payment on insurance claims. Also refers to review of evidence in a trial
Latent - Incubation period. Infections are persistent and go into relapse
JCHAO - Reviews and accredits hospitals
NCQA - Reviews and accredits health plans
ASC - Ambulatory services center. Line by line billing allows for less costs
Adverse selection - Attracting patients that are sicker than usual
Admission Certification - Admitting patients that need more care
Single Payer System - Government Run. Care Triad (Cost, quality, access)
Evidence Based Medicine - Uses EMR of patient to determine the best treatment
National Labor Relations Act - Allows hospital/heath care providers to use bargaining units
Fair Labor Standards Act of 1938 - Establishes Minimum Wage, Ages, overtime pay for workers
Equal Pay Act - Pay equality amongst genders
HEDIS - Compares health plan performance
OASIS - Reimbursement for home health care plans
, UHDDS - Uniform health discharge data set. Needed for Medicare reporting
OSHA - Establishes and regulates workplace safety
Protected Health Information - Records of a patient's past and present health condition, how the
care was provided and how the patient paid
HIPPA - Health Information Privacy and Portability act
Provisions of HIPPA - Cannot be denied coverage for group insurance, coverage wait cannot exceed
12-18 months, safeguards electronc information, privacy of health records
Copay - Payment defined by policy that grants access to the treatment
Premiums - Money paid to insurers to negate the risk of loss. Lower payments result in high
treatment costs
HMO - Health Maintenance Organization: Individuals pay a fixed amount and get access to facilities
within the plan
PPO - Typical insurance style. Individuals pay a fee for service along with copay and deductables
through a network of providers
POS - Similar to a HMO, but with extentions through payment similar to a PPO plan
HDHP - Insurance plan for high risk individuals. Low premium but has high deductables
Medicare - Health care plan entitled to people 65 and older
Medicaid - Health care plan granted by states to low income individuals
ERISA - Act that allows employers to set up insurance plans. Also allows funding for Medicaid
