Chapter 17

123456789101112131415161718
Across
  1. 5. report, with regard to workers' compensation, a report that documents the treatment provided, the worker's current medical status, the expected plan of care, the prognosis, and the expected return-to-work date
  2. 9. Security Disability Insurance, federal government program that provides health care coverage to people with low income who are disabled and who do not meet the work requirements of SSI
  3. 10. payer, organization that pays for health care services on behalf of the patient
  4. 12. provider organization, organization that contracts with independent providers to perform services for members at discounted rates
  5. 13. Security Income, federal government program that provides Medicare coverage to disabled workers who have met Social Security requirements for quarters worked, and who disability is not work related
  6. 15. care provider, person or entity responsible for determining when and if a patient needs a specific types of health care
  7. 17. care, care a patient receives to maintain good health and screen for potential health risk
  8. 18. person who holds or owns an insurance policy
Down
  1. 1. conditions, condition for which a patient received treatment in a certain period before beginning coverage with a new insurance
  2. 2. loss, provision in a health insurance policy that limits the maximum amount the patient must pay out-of-pocket for deductibles, copayments, and coinsurance
  3. 3. dollar amount paid to the insurance company to have coverage in force; usually paid monthly;employers may pay part or all of the premium as an employee benefit
  4. 4. disability, disability income insurance policy that has a short waiting period, usually 0 to 14 days, and pays benefits for a limited amount of time, anywhere from 3 months to 2 years
  5. 6. type of insurance in which an employer sets aside a large reserve fund to directly reimburse employees for medical expenses, rather than purchasing a commercial insurance policy
  6. 7. administration, company that processes paperwork for claims for self-insured employer
  7. 8. health insurance, health insurance not provided by the government but by an independent not-for-profit or for-profit company
  8. 9. nursing facility, licensed facility that primarily provides inpatient, skilled nursing care to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital
  9. 11. value unit, unit of measure assigned to medical services based on the resources required to provide it
  10. 14. and casualty insurance, insurance on homes, cars, and businesses that protects the policyholder against the loss of or damage to physical property they own and against legal liability for losses caused by injury to others, including medical expenses of those injured
  11. 16. a claim that is returned without processing to the provider due to a technical error
  12. 18. fee scale, provider's fee schedule that charges varying fees for a service based on a patient's financial ability to pay