Insurance Terminology Review

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Terms and concepts

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Professor Jensen

Estados Unidos

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Insurance Terminology Review


Insurance Terminology ReviewVersión en línea Terms and concepts por Professor Jensen 1 What is a deductible in insurance? a A monthly premium you pay for coverage b The total coverage limit per policy c The amount you pay out-of-pocket before the insurer pays. d A penalty for late premium payments 2 What does a premium represent? a The deductible you must meet first b The regular payment to keep the policy active. c The maximum amount the insurer pays d The yearly tax on the policy 3 What is a copayment (copay)? a The insurer's administrative fee b A fixed amount paid at the time of service. c The total coverage limit d The amount deducted from your claim 4 Who is the insured? a The insurance agent b The policy issuer c The person whose risks are covered by the policy. d The beneficiary only in life policy 5 What are exclusions in an insurance policy? a The reimbursement method b The premium due date c Items or events not covered by the policy. d The coverage limit per incident 6 What is a beneficiary? a The policyholder's neighbor b The underwriter of the policy c The person who receives benefits when a claim is paid. d The insurer's claims adjuster 7 What is a claims adjuster? a A person who evaluates and settles claims for loss. b The insurance broker c The premium collector d The policy manager 8 What is a rider in an insurance policy? a A modification added to add or change coverage. b A separate policy bought later c A penalty for late payment d A discount on the premium 9 What does underwriting mean? a The collection of premiums b The process of filing a claim c The process of evaluating risk and setting premiums. d The approval of riders 10 What does a policy lapse mean? a The coverage doubles for a period b The policy ends due to nonpayment or nonrenewal. c The premium is automatically waived d The policy is free for a year 11 What is a carrier? a The doctor. b An insurance company; also known as a third-party pa c The patient. d The person who is sick. 12 What is balanced billing? a Collecting payment from the insured patient of the difference between a provider’s usual fee and a payer’s lower allowed charge. b when the deductible and co-insurance are the same c when the practitioners check book balances. d The clause in insurance policies that states that the insured who has two insurance policies may have only a maximum of 100 percent of the health costs. 13 What is CPT (Current Procedural Terminology)? a A set of diagnostic codes. b Codes for durable medical equipment. c A book published by the American Medical Association and updated annually; contains the most commonly used system of procedure codes. d Medical terminology abbreviations. 14 What is an indemnity plan? a A managed care option that combines features of a traditional HMO and a PPO allowing patients to use out-of-network providers while still using a PCP. b A health benefit program, jointly funded by federal and state governments, designed for people with low incomes who cannot afford medical care. c An insurance plan that provides a percentage of payment to the physician on a fee-for-service basis; the patient assumes responsibility for the remaining portion of the cost.

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Insurance Terminology Review

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Creada por

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Insurance Terminology ReviewVersión en línea

por Professor Jensen

What is a deductible in insurance?

What does a premium represent?

What is a copayment (copay)?

Who is the insured?

What are exclusions in an insurance policy?

What is a beneficiary?

What is a claims adjuster?

What is a rider in an insurance policy?

What does underwriting mean?

What does a policy lapse mean?

What is a carrier?

What is balanced billing?

What is CPT (Current Procedural Terminology)?

What is an indemnity plan?