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Medical Insurance

Teacher: Anderson
Across
Government insurance geared toward, children , women who are pregnant and some disable individuals
Amount paid to insurance before benefits begin
Refers to married couple having dual insurance, the spouse with the earlier birthday, their insurance will be billed for
Determines the medical necessity and appropriateness of a service or procedure.
Identification of the nature of illness, ex; hematuria, allergies
Governs the act of patient's privacy
Type of HMO model
Patient or beneficiary
Down
Fixed payment for covered service
PCP refers patient to endocrinology to help manage patients diabetes
Evaluate and places standards on health care organizations
If insurance does not pay for service or procedure incurred by patient, the patient can file this against the decision
Form required when PCP warrants patient to see a specialist
Insurance governed toward individuals in the military
Remittance form