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MOM BCBS insurance notecards

  1. Prepaid medical plan:
    • people pay in advance for health services they may
    • need
  2. UR--utilization review:
    • a group of local physicians get together to examine
    • possible misuse of BS benefits by their peer physicians
  3. Participating Physician (PAR)
  4. Physicians who enter into a contract agreement with the Blues and agree to accept payment based on the UCR as payment in full
  5. Non participating doctor (NON PAR):
    • provider who has not signed an agreement with BCBS
    • *This physician can collect entire bill from patient
    • *Check goes to patient, though.
  6. What does a basic insurance plan cover? (7)
    Hospitalization, diagnostic lab and x-ray, surgery fees, assistant surgeon fees, OB and newborn care, intensive care, chemo for cancer
  7. What does major medical cover?
Author
Anonymous
ID
209691
Card Set
MOM BCBS insurance notecards
Description
MOM BCBS insurance notecards
Updated

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