Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

journal article

Financially Catastrophic and High-Cost Cases: Definitions, Distinctions, and Their Implications for Policy Formulation

Inquiry

Vol. 23, No. 4 (Winter 1986)

, pp. 382-394 (13 pages)

Published By: Sage Publications, Inc.

https://www.jstor.org/stable/29771827

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Abstract

To facilitate discourse and improve the formulation of policy, a clear distinction should be made between financially catastrophic and high-cost health care expenditures. I propose that "financially catastrophic" be used to describe cases whose expenditures are large relative to ability to pay (e.g., when out-of-pocket medical expenditures exceed 15% of annual family income) and that "high cost" describe cases whose total expenditures exceed a set amount (e.g., $10,000 in a year's time) regardless of source of payment or ability to pay. Using these distinctions, I show how third-party coverage and other resources determine whether a high-cost case or illness is also financially catastrophic. I illustrate the usefulness of the proposed categorization by applying it to several current policy issues.

Publisher Information

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 900 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. www.sagepublishing.com

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50 Questions  |  By Gladys102103 | Last updated: Mar 19, 2022 | Total Attempts: 3798

Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called
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Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

NCCT - MEDICAL OFFICE MANAGEMENT - PART C - FINANCIAL MANAGEMENT


  • 1. 

    A BED PATIENT IN A HOSPITAL IS CALLED A(N)?

    • A. 

      INPATIENT

    • B. 

      OUTPATIENT

    • C. 

      THIRD PARTY PAYER

    • D. 

      PROVIDER

  • 2. 

    A PERSON WHO REPRESENTS EITHER PARTY OF AN INSURANCE CLAIM IS THE?

    • A. 

      DOCTOR

    • B. 

      ADJUSTER

    • C. 

      PROVIDER

    • D. 

      SUBSCRIBER

  • 3. 

    A REQUEST FOR PAYMENT UNDER AN INSURANCE CONTRACTOR BOND IS CALLED A(N)?

    • A. 

      INSURANCE APPLICATION

    • B. 

      CLAIM

    • C. 

      DUAL CHOICE REQUEST

    • D. 

      TOTAL DISABILITY

  • 4. 

    PAYMENT MADE PERIODICALLY TO KEEP AN INSURANCE POLICY IN FORCE IS CALLED?

    • A. 

      TIME LIMIT

    • B. 

      PREMIUM

    • C. 

      COINSURANCE

    • D. 

      FEE-FOR-SERVICE

  • 5. 

    A PERSON OR INSTITUTION THAT GIVES MEDICAL CARE IS A(N)?

    • A. 

      THIRD-PARTY PAYER

    • B. 

      PROVIDER

    • C. 

      ADJUSTER

    • D. 

      INSURANCE AGENT

  • 6. 

    BENEFITS THAT ARE MADE IN THE FORM OF CASH PAYMENTS ARE KNOWN AS?

    • A. 

      INDEMNITIES

    • B. 

      DEDUCTIBLES

    • C. 

      MEDICAL CO-PAYS

    • D. 

      CASH ADVANCES

  • 7. 

    AN AMOUNT THE INSURED MUST PAY BEFORE POLICY BENEFITS BEGIN IS CALLED?

    • A. 

      INDEMNITY

    • B. 

      EXTENDED BENEFITS

    • C. 

      DEDUCTIBLE

    • D. 

      CATASTROPHIC

  • 8. 

    AN ORGANIZATION THAT OFFERS HEALTH INSURANCE AT A FIXED MONTHLY PREMIUM WITH LITTLE OR NO DEDUCTIBLE & WORKS THROUGH A PRIMARY CARE PROVIDER IS CALLED A(N)?

    • A. 

      PREFERRED PROVIDER

    • B. 

      HEALTH MAINTENANCE ORGANIZATION

    • C. 

      MEMBER PHYSICIAN

    • D. 

      PRIVATE HEALTH PROVIDER

  • 9. 

    HEALTH INSURANCE THAT PROVIDES PROTECTION AGAINST THE HIGH COST OF TREATING SEVERE OR LENGTHY ILLNESSES OR DISABILITIES IS CALLED?

    • A. 

      CATASTROPHIC

    • B. 

      SEVERE

    • C. 

      THIRD-PARY PAYER

    • D. 

      NO CORRECT ANSWER

  • 10. 

    A PATIENT RECEIVING AMBULATORY CARE AT A HOSPITAL OR OTHER HEALTH FACILITY WITHOUT BEING ADMITTED AS A BED PATIENT IS CALLED A(N)?

    • A. 

      INPATIENT

    • B. 

      OUTPATIENT

    • C. 

      CARRIER

    • D. 

      ADJUSTER

  • 11. 

    AN INJURY THAT PREVENTS A WORKER FROM PERFORMING ONE OR MORE OF THE REGULAR FUNCTIONS OF HIS JOB WOULD BE KNOW AS A?

    • A. 

      PARTIAL DISABILITY

    • B. 

      PERMANENT DISABILITY

    • C. 

      TOTAL DISABILITY

    • D. 

      RESULTANT DISABILITY

  • 12. 

    A PREVIOUS INJURY, DISEASE OR PHYSICAL CONDITION THAT EXISTED BEFORE THE HEALTH INSURANCE POLICY WAS ISSUED IS CALLED?

    • A. 

      PREEXISTING CONDITION

    • B. 

      PRIOR EXPOSURE

    • C. 

      FOREGOING CONDITION

    • D. 

      NO CORRECT ANSWER

  • 13. 

    ONE WHO BELONGS TO A GROUP INSURANCE PLAN IS CALLED?

    • A. 

      THIRD-PARTY PAYER

    • B. 

      SUBSCRIBER

    • C. 

      CARRIER

    • D. 

      NO CORRECT ANSWER

  • 14. 

    A SUM OF MONEY PROVIDED IN AN INSURANCE POLICY, PAYABLE FOR COVERED SERVICES IS CALLED?

    • A. 

      DEDUCTIBLE

    • B. 

      BENEFITS

    • C. 

      DUES PAYABLE

    • D. 

      PREMIUM

  • 15. 

    TO PREVENT THE INSURED FROM RECEIVING A DUPLICATE PAYMENT FOR LOSSES UNDER MORE THAN ONE INSURANCE POLICY IS CALLED?

    • A. 

      FEE-FOR-SERVICE

    • B. 

      HOSPITAL BENEFITS

    • C. 

      COORDINATION OF BENEFITS

    • D. 

      NON DUPLICATION BENEFITS

  • 16. 

    WHEN A PATIENT HAS HEALTH INSURANCE, THE PERCENTAGE OF COVERED SERVICES THAT IS THE RESPONSIBILITY OF THE PATIENT TO PAY IS KNOW AS?

    • A. 

      COINSURANCE

    • B. 

      PRE-DEFINED POLICY

    • C. 

      COMPREHENSIVE

    • D. 

      IN PERCENT POLICY

  • 17. 

    INSURANCE THAT IS MEANT TO OFFSET MEDICAL EXPENSES RESULTING FROM A CATASTROPHIC ILLNESS IS CALLED?

    • A. 

      PRIMARY INSURANCE

    • B. 

      MAJOR MEDICAL

    • C. 

      WHOLE LIFE POLICY

    • D. 

      COMPREHENSIVE

  • 18. 

    AN UNEXPECTED EVENT WHICH MAY CAUSE INJURY IS CALLED?

    • A. 

      DREAD DISEASE RIDER

    • B. 

      ACCIDENT

    • C. 

      ADJUSTER

    • D. 

      NO CORRECT ANSWER

  • 19. 

    A DOCTOR WHO AGREES TO ACCEPT AN INSURANCE COMPANIES PRE-ESTABLISHED FEE AS THE MAXIMUM AMOUNT TO BE COLLECTED IS CALLED?

    • A. 

      SUBSCRIBER

    • B. 

      CLAIM REPRESENTATIVE

    • C. 

      PARTICIPATING PHYSICIAN

    • D. 

      ADJUSTER

  • 20. 

    INSURANCE PLANS THAT PAY A PHYSICIAN'S FULL CHARGE IF IT DOES NOT EXCEED HIS NORMAL CHARGE OR DOES NOT EXCEED THE AMOUNT NORMALLY CHARGED FOR THE SERVICE IS CALLED?

    • A. 

      USUAL, CUSTOMARY AND REASONABLE

    • B. 

      COMPREHENSIVE

    • C. 

      DUAL CHOICE

    • D. 

      NO CORRECT ANSWER

  • 21. 

    A NOTICE OF INSURANCE CLAIM OR PROOF OF LOSS MUST BE FILED WITHIN A DESIGNATED __________ OR IT CAN BE DENIED?

    • A. 

      WAITING PERIOD

    • B. 

      POLICY DATE

    • C. 

      TIME LIMIT

    • D. 

      GRACE PERIOD

  • 22. 

    A HEALTH PROGRAM FOR PEOPLE AGE 65 AND OLDER UNDER SOCIAL SECURITY IS CALLED?

    • A. 

      TRI-CARE

    • B. 

      MEDICARE

    • C. 

      CHAMPVA

    • D. 

      WORKERS' COMPENSATION

  • 23. 

    A CIVILIAN HEALTH & MEDICAL PROGRAM OF THE UNIFORM SERVICES IS CALLED?

    • A. 

      TRI-CARE

    • B. 

      MEDICARE

    • C. 

      MEDICAID

    • D. 

      WORKERS' COMPENSATION

  • 24. 

    A FORM OF INSURANCE PAID BY THE EMPLOYER PROVIDING CASH BENEFITS TO WORKERS INJURED OR DISABLED IN THE COURSE OF EMPLOYMENT IS CALLED?

    • A. 

      TRI-CARE

    • B. 

      CHAMPUS

    • C. 

      WORKERS' COMPENSATION

    • D. 

      MEDICAID

  • 25. 

    A RECAP SHEET THAT ACCOMPANIES A MEDICARE OR MEDICAID CHECK, SHOWING BREAKDOWN & EXPLANATION OF PAYMENT ON A CLAIM IS CALLED?

    • A. 

      FEE-FOR-SERVICE

    • B. 

      EXPLANATION OF BENEFITS

    • C. 

      COORDINATION OF BENEFITS

    • D. 

      DUAL CHOICE

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    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

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    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

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  • Sample Question

    To ensure that the medical office has the supplies it needs, the medical assistant should establish a(n) __________.

    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

    Reorder point

    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

    Inventory control log

    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

    Order quantity

    Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called

    All answers are correct

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Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called
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Which provides coverage for catastrophic or prolonged illness?

What is a third party administrator? Major medical insurance policies provide coverage for catastrophic or prolonged illnesses and injuries. Most of these programs have large deductibles and lifetime maximum amounts.

What is the term for a payment made periodically to keep an insurance policy in force?

Payment made periodically to keep an insurance policy in force is called. premium.

What's the term for the amount paid by the insurance company for covered medical expenses?

Deductible: The amount that the insured must pay each policy year to cover medical care expenses before the insurance policy starts paying. Deductibles are typically a set amount annually, but some plans require a deductible based on diagnosis rather than based on time.

Which of the following health insurance coverages is best suited for meeting the expenses of catastrophic illness?

Which of the following health insurance coverages is BEST suited for meeting the expenses of catastrophic illness? ( Major Medical health insurance coverage is best suited for meeting catastrophic illness expenses.)