umbrella term for all healthcare plans that focus on reducing the cost of delivering quality care to patient members in return for scheduled payments and coordinated care through a defined network of primary care physicians and is a healthcare provider who enters into a contract with a specific is a process required by some insurance carriers in which the provider obtains 20. The payment of a specific sum of money to an insurance company for a list of health insurance benefits is called carepovider who can approve or deny when a patient seeks additional care is refered to as al(m) 22. An insurance term used when a primary care provider wants to send a patient to a specialist is 23. The fee schedule designed to provide national uniform payment of Medicare benefits after adjustment to reflect the is funded by an organization with an employee base large enough to enable hospitals is 18. A(n) insurance company or program and agrees to accept the contracted fee schedule. 19. to perform certain procedures or services or to refer a patient to a specialist ain) differences in practice costs across geographic areas is called the 24. A(n) it to fund its own insurance program 25. The intermediary and administrator who coordinates patients and providers and processes claims for self-funded plans is called atn) 26. A government-sponsored program under which authorized dependents of military personnel receive medical care was originally called CHAMPUS but now is called 27. A(n) is a review of individual cases by a committee to make sure services are medically necessary and to study how providers use medical care resources. 28. is an insurance plan for individuals who are injured on the job either by acci- dent or an acquired illness. 29. Health insurance plans pay for health services deemed 30. The 31. Low- and middle-income Americans can purchase health insurance at alrn) was passed in 2010 to assist more Americans in obtaining health insurance to apply for health insurance and not worry about being denied for a pre-existing condition 32. There are resources for patients who have questions on health insurance coverage through the Patient Protection and Affordable Care Act, such as 33. Benefits cover the or the amount that should be paid to the healthcare provider for services rendered 34. Patients have a higher financial responsibility when they access care that is benefits. are used by many healthcare facility offices to quickly verify eligibility and 36. When a provider agrees to become a PAR, they also agree to the health insurance plan\'s for rendered medical services. Solution 17. Managed care plans 18 .Participating provider 19. Preauthorization 20. Premium 21. gatekeeper 22..refferal 23.resource based relative value scale 24. Self Insured plan 25. Third Party admintrator 26 TRICARE 27.Utilization review 28 Workers Comp 29 Medically Necessary 30 Patient Protection and affordable care act 31 Insurance market places 32 Navigator Program 33amount loss .

1. umbrella term for all healthcare plans that focus on reducing the cost of delivering quality care
to patient members in return for scheduled payments and coordinated care through a defined
network of primary care physicians and is a healthcare provider who enters into a contract with a
specific is a process required by some insurance carriers in which the provider obtains 20. The
payment of a specific sum of money to an insurance company for a list of health insurance
benefits is called carepovider who can approve or deny when a patient seeks additional care is
refered to as al(m) 22. An insurance term used when a primary care provider wants to send a
patient to a specialist is 23. The fee schedule designed to provide national uniform payment of
Medicare benefits after adjustment to reflect the is funded by an organization with an employee
base large enough to enable hospitals is 18. A(n) insurance company or program and agrees to
accept the contracted fee schedule. 19. to perform certain procedures or services or to refer a
patient to a specialist ain) differences in practice costs across geographic areas is called the 24.
A(n) it to fund its own insurance program 25. The intermediary and administrator who
coordinates patients and providers and processes claims for self-funded plans is called atn) 26. A
government-sponsored program under which authorized dependents of military personnel
receive medical care was originally called CHAMPUS but now is called 27. A(n) is a review of
individual cases by a committee to make sure services are medically necessary and to study how
providers use medical care resources. 28. is an insurance plan for individuals who are injured on
the job either by acci- dent or an acquired illness. 29. Health insurance plans pay for health
services deemed 30. The 31. Low- and middle-income Americans can purchase health insurance
at alrn) was passed in 2010 to assist more Americans in obtaining health insurance to apply for
health insurance and not worry about being denied for a pre-existing condition 32. There are
resources for patients who have questions on health insurance coverage through the Patient
Protection and Affordable Care Act, such as 33. Benefits cover the or the amount that should be
paid to the healthcare provider for services rendered 34. Patients have a higher financial
responsibility when they access care that is benefits. are used by many healthcare facility offices
to quickly verify eligibility and 36. When a provider agrees to become a PAR, they also agree to
the health insurance plan's for rendered medical services.
Solution
17. Managed care plans
18 .Participating provider
19. Preauthorization
20. Premium
21. gatekeeper

2. 22..refferal
23.resource based relative value scale
24. Self Insured plan
25. Third Party admintrator
26 TRICARE
27.Utilization review
28 Workers Comp
29 Medically Necessary
30 Patient Protection and affordable care act
31 Insurance market places
32 Navigator Program
33amount loss
34 out of network
35 Online Web portal