405_insurance

The flashcards below were created by user itzlinds on FreezingBlue Flashcards.

the internal/family medicine physician responsible for coordinating the care of his or her pt.

primary care physican
amount paid by the subscriber for the policy is called:

premium

often paid by the employer
the amount the subscriber is responsible for paying prior to the insurance company taking responsibility for the claim is called:

deductible

premium and deductible have an inverse relationship
the amount paid by the subscriber upon visit to the provider prior to receiving services:

co pay

some policies limit the total amount of co pay per year
applied after the deductible amount has been met by another subscriber is called:

co insurance

a % of the remaining balance
services provieded by perapproved providers for which the insurance company negotiates a fee for that service

in network benefits

cost savings due to lower fees from negotiation
an agreement b/w insurer and a network
allows flexibility for the pt; patient does not need referral for a physican

PPO
the type of insurance plan in which similar to PPO, but funded by individuals or employer groups, & uniquely arranged from company to company

HSA Health Savings Account

a TAX FREE ACCOUNT
provides health insurance to retired individuals, regardless of their medical conditions, over the age of 65 is

medicare
joint fed-state program; that mets two eligibility requirements called:

medicaid
cost containment considerations:

can be difficult to coordinate due to:
- timing of injury
- where the athletes is from
- type of insurance plan the student carries
list 2 problems with mandating primary insurance:
- some students do not have insurace
- some insurance (HMO, PPO) many not cover the athlete at the school
what are the benefits to changing the PCP:

if possible, change the students PCP to a campus physician; this makes the college resources in network

some insurances allow exemption for out of network issues

Author

itzlinds

290614

Card Set

405_insurance

Description

405 insurance

Updated

2014-12-12T02:10:32Z

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