aop test ch3&7
Terms
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- precertification
- discovering whether a treatment is covered under a patient's contract
- the civilian health and medical program of the department of veterans affairs (champva)
- a program for veterans with total, permanent, service-connected disabilities or surviving spouses and dependents of veterans who died of service-connected disabilities
- TRICARE
- a three-option managed health care program offered to spouses and dependents of service personnel with uniform benefits and fees implemented nationwide by the federal government
- independent or individual practice association (IPA)
- a type of hmo in which a program administrator contracts with a number of physicians who agree to provide treatment to subscribers in their own offices
- state disability insurance
- insurance that covers off-the-job injury or sickness and is paid for by deductions from a person's paycheck.
- individual contract
- any insurance plan issued to an individual
- insured
- an individual or organization protected in case of loss under the terms of an insurance policy
- predetermination
- discovering the maximum dollar amount that the carrier will pay for surgery, consulting services, radiology procedures, and so on
- medicare
- a nationwide health insurance program for persons 65 years of age and older and certain disabled or blind persons regardless of income, administered by HCFA
- preauthorization
- whether a service or procedure is covered, but also to finding out whether it is medically necessary
- health maintenance organization (hmo)
- the oldest of all prepaid plans. a comprehensive health care financing and delivery organization that provides a wide range of health care services with an emphasis on preventive medicine to enrollees within a geographic area through a panel of providers.
- workers' compensation
- a contract that insures a person against on-the-job injury and illness.
- disability income insurance
- a form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease
- medicaid
- a federally aided, state-operated an -administered program that provides medical benefits for certain low-income persons in need of health and medical care