Question
19. I is a process required by some insurance carriers in which the provider obtains authorization to perform certain procedures or services or to refer a patient to a specialist. 20. The payment of a specific sum of money to an insurance company for a list of health insurance benefits is called a(n) 21. The primary care provider who can approve or deny when a patient seeks additional care is referred to as a(n) 22. An insurance term used when a primary care provider wants to send a patient to a specialist is referral 23. The fee schedule designed to provide national uniform payment of Medicare benefits after adjustment to reflect the differences in practice costs across geographic areas is called the resource-based relative value scale (RBRVS). 24. A(n) large enough to enable it to fund its own insurance program is funded by an organization with an employee base 25. The intermediary and administrator who coordinates patients and providers and processes claims for self-funded plans is called a(n) 26. A government-sponsored program under which authorized dependents of military personnel receive Medical Care was originally called CHAMPUS but now is calledTricare is a review of individual cases ofa 27. A(n) _Utilization review committee to make sure services are medically necessary and to study how providers use medical care resources. is an insurance plan for individuals 28. Worker's compensation who are injured on the job either by accident or an acquired illness. 1.425
Explanation / Answer
19. insurance claim
20. health insurance premium money
21. Health care administrator
22. referral physician that is taking second opinion on the case.
23. resource based relative value scale.
24. Home care
25. Nursing manager or administrator
26. Tricare Home plan.
27. Utilization review is the process used by employers or claim administrators
28. worker insurance
26. Tricare Home plan.
27. Utilization review is the process used by employers or claim administrators
29. by peer review
30. Affordable care act
31. Medicaid
32. Health care management
33. therapy
34. Expensive and unafforadable
35. Healthcare insurance eligibility
36. coverage of cost
37. The hospital facility amount
38. accrediated and authorised
39. Physician work, physician expense, professional liability insurance
40. Almost all type of healthcare providers
41. application for appointment with referral physician
42. and medicaid.
