#1
What is a pre-authorization in health insurance claim processing?
A process where the insurer confirms coverage before a medical service is provided
ExplanationInsurance confirmation before treatment
#2
What does EOB stand for in health insurance?
Explanation of Benefits
ExplanationExplanation of covered benefits
#3
What does COBRA stand for in health insurance?
Consolidated Omnibus Budget Reconciliation Act
ExplanationLegislation for continuation of coverage
#4
What is the purpose of a Explanation of Benefits (EOB) statement?
To explain the benefits covered under a health insurance plan
ExplanationExplanation of covered benefits
#5
Which of the following is NOT a common reason for denying a health insurance claim?
Incorrect patient address
ExplanationPatient address discrepancy
#6
What is coordination of benefits (COB) in health insurance?
A process where multiple insurers work together to determine coverage
ExplanationMultiple insurers coordinating coverage
#7
What is medical underwriting in health insurance?
The process of assessing an individual's health status for insurance coverage
ExplanationAssessment of health status for coverage
#8
What is a deductible in health insurance?
The amount the insured must pay out-of-pocket before the insurance company pays
ExplanationInitial out-of-pocket payment
#9
What is meant by 'clean claim' in health insurance?
A claim submitted with all required information and without errors
ExplanationError-free claim submission
#10
What is a 'lifetime maximum' in health insurance?
The maximum amount the insurer will pay over the insured's lifetime
ExplanationMaximum lifetime coverage amount
#11
What is 'subrogation' in health insurance?
A process where the insurer recovers costs from a third party
ExplanationInsurer recovering costs from third party