Billing and Coding II Mid Term

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Across
  1. 2. / Which type of consumer-driven health plan funding option is set up and funded by employers?
  2. 3. / type of plan is a hybrid of two networks, where members may choose from a primary or secondary network
  3. 7. / _______ enrollee refers to an individual who enrolls in a health plan after the original enrollment date
  4. 8. / After providing treatment, the provider submits the claim to the local BCBS plan in his or her service area, which is referred to as the ____ plan.
  5. 10. / Medicare was originally called Medicare+ __________.
  6. 13. / What type of plan requires premium, deductible, and coinsurance payments and typically cover 70 to 80 percent
  7. 15. / which step comes first in the standard medical billing cycle
  8. 16. / 115 percentage of the fee on the Medicare NonPAR Fee Schedule is the __________ CHARGE.
  9. 18. costs for covered benefits after deductibles are met
  10. 19. / Which type of deductible can be met by combining payments?
Down
  1. 1. / Which type of consumer-driven health plan funding option can be funded by both employers and employees?
  2. 2. / A patient's ________________ plan processes the BCBS claim and sends it back to the host plan.
  3. 3. / most popular type of private health plan
  4. 4. / What type of private payer offers lower costs, but also has the most stringent guidelines and the narrowest choice
  5. 5. / What type of surgery is a procedure that can be scheduled ahead of time, but which may or may not be medically necessary?
  6. 6. / private insurance that beneficiaries may purchase to fill in some of the gaps—unpaid amounts—in Medicare coverage
  7. 9. / Which program under Medicaid offers health insurance coverage for uninsured children?
  8. 11. / Which type of consumer-driven health plan funding option is set up by individuals rather than employers?
  9. 12. / What is performed for a patient who does not have symptoms, abnormal findings, or any past history of the disease
  10. 13. / If the policy states an amount which must be met for each enrollee, what kind of deductible is it?
  11. 14. / ___________ period is the amount of time that must pass before an employee can enroll in a health plan
  12. 17. / Which program under Medicaid offers financial assistance for people with low incomes and few resources?
  13. 20. / If a Medicare PAR physician thinks that a planned procedure will not be found medically necessary by Medicare and so will not be reimbursed, the patient should be asked to sign a(n)