HAN 300 FINAL REVIEW questions with
correct answers
health care - Answer the treatment of illness and maintenance of health
finance - Answer funding
health care financing - Answer funding for the treatment of illness and
maintenance of health
insurance - Answer protects against risk
insured - Answer (also called beneficiary) some who is covered by insurance
beneficiary - Answer a person who derives advantage from something, especially
a trust, will or life insurance policy
insurer - Answer a person or company that underwrites an insurance risk; the
party in an insurance contract undertaking to pay compensation
underwriting - Answer process that insurer does to evaluate, selecting or rejecting
classifying and rating risk
o 4 types:
Risk is unpredictable for the individual insured
Reasonable can be predicted with a reasonable degree of accuracy
Insurance can transfer risk from group to individual through pooling of resources
Losses are shared by all members
,experience rating - Answer premium can be unaffordable for high-risk groups
most commonly associated with worker's compensation insurance
community rating - Answer good risks subsidize poor risks
adjusted community rating - Answer (required by ACA): takes into account
individual vs. family enrollment, geographic area, age, tobacco use
benefits - Answer services covered by an insurance plan
copayment - Answer flat amount paid per service
coinsurance - Answer set proportion of medical costs insured pay out of pocket
o Ex. you pay 20% the insurance pays 80%
deductible - Answer amount the insured pays first before benefits are paid by the
plan
o Applied annually
service description - Answer a description of the health care services you
received, like a medical visit, lab tests, or screenings
provider charges - Answer is the amount your provider bills for your visits
allowed charges - Answer is the amount your provider will be reimbursed; this
may not be the same as the provider charges.
, paid by the insurer - Answer the amount your insurance plan will pay to your
provider
payee - Answer the person who will receive any reimbursement for over-paying
the claim
what you owe - Answer the amount the patient or insurance plan member owes
after your insurer has pay everything else. You may have already paid a portion of
this amount, and payments made directly to your provider may not be subtracted
from this amount
remark code - Answer a note from the insurance plan that explains more about the
costs, charges and paid amounts for your visit.
premium - Answer amount charged by the insurer per month to prevent risk
deductible - Answer annual payment for insurance price based on the plan you
choose before they cover something
health savings account - Answer accounts you can draw from to cover health
expenses
minimal essential coverage - Answer complies with the coverage for the
Affordable Care Act that covers free preventative care
o Ex. preventative care, birth control
correct answers
health care - Answer the treatment of illness and maintenance of health
finance - Answer funding
health care financing - Answer funding for the treatment of illness and
maintenance of health
insurance - Answer protects against risk
insured - Answer (also called beneficiary) some who is covered by insurance
beneficiary - Answer a person who derives advantage from something, especially
a trust, will or life insurance policy
insurer - Answer a person or company that underwrites an insurance risk; the
party in an insurance contract undertaking to pay compensation
underwriting - Answer process that insurer does to evaluate, selecting or rejecting
classifying and rating risk
o 4 types:
Risk is unpredictable for the individual insured
Reasonable can be predicted with a reasonable degree of accuracy
Insurance can transfer risk from group to individual through pooling of resources
Losses are shared by all members
,experience rating - Answer premium can be unaffordable for high-risk groups
most commonly associated with worker's compensation insurance
community rating - Answer good risks subsidize poor risks
adjusted community rating - Answer (required by ACA): takes into account
individual vs. family enrollment, geographic area, age, tobacco use
benefits - Answer services covered by an insurance plan
copayment - Answer flat amount paid per service
coinsurance - Answer set proportion of medical costs insured pay out of pocket
o Ex. you pay 20% the insurance pays 80%
deductible - Answer amount the insured pays first before benefits are paid by the
plan
o Applied annually
service description - Answer a description of the health care services you
received, like a medical visit, lab tests, or screenings
provider charges - Answer is the amount your provider bills for your visits
allowed charges - Answer is the amount your provider will be reimbursed; this
may not be the same as the provider charges.
, paid by the insurer - Answer the amount your insurance plan will pay to your
provider
payee - Answer the person who will receive any reimbursement for over-paying
the claim
what you owe - Answer the amount the patient or insurance plan member owes
after your insurer has pay everything else. You may have already paid a portion of
this amount, and payments made directly to your provider may not be subtracted
from this amount
remark code - Answer a note from the insurance plan that explains more about the
costs, charges and paid amounts for your visit.
premium - Answer amount charged by the insurer per month to prevent risk
deductible - Answer annual payment for insurance price based on the plan you
choose before they cover something
health savings account - Answer accounts you can draw from to cover health
expenses
minimal essential coverage - Answer complies with the coverage for the
Affordable Care Act that covers free preventative care
o Ex. preventative care, birth control
