one who acts for the insured or the carrier in a c
a request for payment under an insurance contra
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MOA Midterm/ Final EXAM (Complete
Review)( Midterm - 100 Questions Final
- 200 Questions)Rated 100% Correct!!
A bed patient in a hospital is called _____________.
a. inpatient
b. outpatient
c. third party payer
d. provider - Answer a
One who acts for the insured or the carrier in a claim is called ___________.
a. member physician
b. adjuster
c. provider
d. subscriber - Answer b
A request for payment under an insurance contractor bond is called a(n)
_______________.
a. insurance application
b. claim
c. dual choice request
d. total disability - Answer b
Payment made periodically to keep an insurance policy in force is called
_____________.
a. time limit
b. premium
c. coinsurance
d. fee-for-service - Answer b
A person or institution that gives medical care is a(n) ___________.
a. third-party payer
b. provider
c. adjuster
d. insurance agent - Answer b
Specific hazards or perils listed in an insurance policy for which the insurance
company will not pay is called ___________.
a. elimination period
b. exclusions
c. non duplication of benefits
d. excepted period - Answer b
,MOA Midterm/ Final EXAM (Complete
Review)( Midterm - 100 Questions Final
- 200 Questions)Rated 100% Correct!!
Benefits in the form of cash payments rather than service are called
_____________.
a. indemnity
b. hospital benefits
c. catastrophic health
d. none of the above - Answer a
An amount the insured must pay before policy benefits begin is called
______________.
a. indemnity
b. extended benefits
c. deductible
d. catastrophic - Answer c
An organization that offers insurance against losses in exchange for a premium is
called ____________.
a. rider
b. carrier
c. member physician
d. provider - Answer b
Health insurance that provides protection against the high cost of treating severe or
lengthy illnesses or disabilities is called _____________.
a. catastrophic
b. severe
c. third-party payer
d. none of the above - Answer a
A patient receiving ambulatory care at a hospital or other facility without being
admitted as a bed patient is called a(n) ___________.
a. inpatient
b. outpatient
c. carrier
d. adjuster - Answer b
An illness or injury that prevents an insured from performing one or more of the
functions of his regular job is called a ______________.
a. permanent disability
b. partial disability
c. preexisting condition
,MOA Midterm/ Final EXAM (Complete
Review)( Midterm - 100 Questions Final
- 200 Questions)Rated 100% Correct!!
d. total disability - Answer b
A previous injury, disease or physical condition that existed before the health
insurance policy was issued is called _____________.
a. preexisting condition
b. prior exposure
c. foregoing condition
d. none of the above - Answer a
One who belongs to a group insurance plan is called ___________.
a. third-party payer
b. subscriber
c. carrier
d. none of the above - Answer b
A sum of money provided in an insurance policy, payable for covered services is
called ____________.
a. deductible
b. benefits
c. dues payable
d. premium - Answer b
To prevent the insured from receiving a duplicate payment for losses under more
than one insurance policy is called ____________.
a. fee-for-service
b. hospital benefits
c. coordination of benefits
d. non-duplication benefits - Answer c
A requirement under a health care policy dictates that the insured be responsible for
a percentage of covered services. This is called ____________.
a. coinsurance
b. pre-insurance
c. comprehensive
d. copayment - Answer a
Period of time after the beginning of the disability for which no benefits are payable is
called ___________.
a. extended benefits
b. grace period
, MOA Midterm/ Final EXAM (Complete
Review)( Midterm - 100 Questions Final
- 200 Questions)Rated 100% Correct!!
c. elimination period
d. time limit - Answer c
Insurance designed to offset medical expenses resulting from catastrophic or
prolonged illness or injury is called _________.
a. extended benefits
b. major medical
c. copayment
d. none of the above - Answer b
An unexpected event which may cause injury is called __________.
a. dread disease rider
b. accident
c. adjuster
d. none of the above - Answer b
A doctor who agrees to accept an insurance companies pre established fee as the
maximum amount to be collected is called ____________.
a. subscriber
b. claim representative
c. participating physician
d. adjuster - Answer c
An illness or injury that temporarily prevents an injured person from performing their
regular job is called a ____________.
a. partial disability
b. total disability
c. temporary disability
d. none of the above - Answer c
An illness or injury that permanently prevents an insured person from performing
their regular job is called ____________.
a. temporary disability
b. pre existing condition
c. permanent disability
d. none of the above - Answer c
Insured plans that pay a physician's full charge if it does not exceed his normal
charge or does not exceed the amount normally charged for the service by other
physicians in the area, and is otherwise reasonable is called ________________.
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