Medical Insurance Chapter 13th BlueCross BlueShiel
Medical Insurance Chapter 13th BlueCross BlueShiel
Exam (elaborations)
Medical Insurance Chapter 13th BlueCross BlueShield Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.
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Course
Medical Insurance Chapter 13th BlueCross BlueShiel
Institution
Medical Insurance Chapter 13th BlueCross BlueShiel
BCBS indemnity coverage is characterized by certain limitations, including - hospital-only or
comprehensive hospital and medical coverage
One of the requirements that a participating provider must comply with is to - make fee
adjustments for the difference between amounts charged to patients for...
Medical Insurance Chapter 13th
BlueCross BlueShield
BCBS indemnity coverage is characterized by certain limitations, including - hospital-only or
comprehensive hospital and medical coverage
One of the requirements that a participating provider must comply with is to - make fee
adjustments for the difference between amounts charged to patients for services provided and payer-
approved fees.
Which is a program that requires providers to adhere to managed care provisions? - preferred
provider network (PPN)
One of the expectations that a nonparticipating provider has is to _____ for services rendered. -
obtain payment for the full fee charged
Which is considered a minimum benefit under BCBS basic coverage? - hospitalizations
Which is considered a service reimbursed by BCBS major medical coverage? - mental health visits
Which is a special clause in an insurance contract that stipulates additional coverage over and above the
standard contract? - riders
Prospective authorization or precertification is a requirement of the _____ BCBS managed care plan. -
outpatient pretreatment authorization
Which phrase is located on a Federal Employee Program plan ID card? - Government-Wide Service
Benefit Plan
The plan ID card for a subscriber who opts for BCBS's Health Care Anywhere PPO coverage uniquely
contains the _____ logo. - suitcase
Which Texas hospitalization plan began in 1929 and guaranteed 21 days of coverage per year? -
Blue Cross
In 1938, the Blue Shield plan originated to cover what type of fees? - physician services
Charitable, educational, civic, or humanitarian organizations whose profits are returned to the program
of the corporation rather than to shareholders are called: - nonprofit corporations
A for-profit corporation pays taxes on: - profits generated by the corporation's for-profit
enterprises
A member hospital is one that has signed a contract to: - provide services for special rates
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