bcbs test Questions With Complete Solutions
AHA Correct Answers American hospital Assc. national
organization that represents, hospitals,healthcare, and their
patients
annual deducible Correct Answers patients required amount to
pay before insurnace will take over
assignment of benefits Correct Answers payment is made
directly to provider by BCBS
balance billing Correct Answers not allowed
BCBS can cancell you in non profit status
when Correct Answers premiums aren't paid
fraudulent info
BCBS maintain negotiated contracts with providers because
Correct Answers prompt payment to PAR
maintain professional representatives
provide educational semiars, workshops and manuals
publish name of provider as advertising
blue cross began when and where
for what Correct Answers 1929 at baylour un. in dallas texas
for hospital bills
blue shield began when and where for what Correct Answers
1938 at house of delegates for physician services
, difference between primary and secondary insurnace Correct
Answers patient whi has insurance through there work is
primary any other insurance are secondary
difference in copayment and coinsurance Correct Answers
copay is a set $ amount and coinsurance is 20-25% of payment
exclusive provider Correct Answers managed care plan that
provides benefits to subscribers if they receive services from
network providers (doctors) not required to select PCP & don't
need a referral to see a specialist
exclusive provider organization Correct Answers EPO, A type
of managed health care plan that combines features of HMOs
and PPOs. it is referred to as "exclusive" because it is offered to
large employers who agree not to contract with any other plan.
EPOs are regulated under state health insurance laws.
fee for service Correct Answers An established schedule of
fees set for services performed by providers and paid by the
patient.
FEP Federal employee health programs Correct Answers is for
goverment empkloyees and card will have goverment wide
service plan with ID# will be 3 digits
for profit corp Correct Answers pay taxes on profits and pay
shareholders on after tax profits
AHA Correct Answers American hospital Assc. national
organization that represents, hospitals,healthcare, and their
patients
annual deducible Correct Answers patients required amount to
pay before insurnace will take over
assignment of benefits Correct Answers payment is made
directly to provider by BCBS
balance billing Correct Answers not allowed
BCBS can cancell you in non profit status
when Correct Answers premiums aren't paid
fraudulent info
BCBS maintain negotiated contracts with providers because
Correct Answers prompt payment to PAR
maintain professional representatives
provide educational semiars, workshops and manuals
publish name of provider as advertising
blue cross began when and where
for what Correct Answers 1929 at baylour un. in dallas texas
for hospital bills
blue shield began when and where for what Correct Answers
1938 at house of delegates for physician services
, difference between primary and secondary insurnace Correct
Answers patient whi has insurance through there work is
primary any other insurance are secondary
difference in copayment and coinsurance Correct Answers
copay is a set $ amount and coinsurance is 20-25% of payment
exclusive provider Correct Answers managed care plan that
provides benefits to subscribers if they receive services from
network providers (doctors) not required to select PCP & don't
need a referral to see a specialist
exclusive provider organization Correct Answers EPO, A type
of managed health care plan that combines features of HMOs
and PPOs. it is referred to as "exclusive" because it is offered to
large employers who agree not to contract with any other plan.
EPOs are regulated under state health insurance laws.
fee for service Correct Answers An established schedule of
fees set for services performed by providers and paid by the
patient.
FEP Federal employee health programs Correct Answers is for
goverment empkloyees and card will have goverment wide
service plan with ID# will be 3 digits
for profit corp Correct Answers pay taxes on profits and pay
shareholders on after tax profits
