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1: Navigating the US Healthcare System

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Welcome: Navigating US Healthcare System

1 Quiz
- 1.1 Navigating Healthcare – Student
Bonus: History of Health Insurance in US
Important Players

1 Quiz
- 1.2 Important Players – Student
How We Pay for Healthcare: Insurance Plans

1 Quiz
- 1.3 Insurance Plans – Student
Health Insurance Terms

1 Quiz
- 1.4 Health Insurance Terms – Student
Bonus: Health Savings Accounts & Flexible Spending Accounts
Medicare

1 Quiz
- 1.5 Medicare – Student
Reimbursement Types

1 Quiz
- 1.6 Reimbursement Types – Student
Quality Measures

1 Quiz
- 1.7 Quality Measures – Student

Quiz 4 of 7

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1.4 Health Insurance Terms – Student

1: Navigating the US Healthcare System Health Insurance Terms 1.4 Health Insurance Terms – Student

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Question 1 of 5

1. Question
What is the fixed amount payment made by the patient in addition to the payment from the insurer?
- Co-pay
- Deductible
- Premium
- Co-insurance
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Question 2 of 5

2. Question
If a service is listed as a covered benefit by the insurer, but additional documentation and forms are required for approval/coverage, this process is called ______.
- preauthorization
- in-network
- out-of-network
- medical necessity
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Question 3 of 5

3. Question
What is one consideration when working with a patient with visit limitations?
- Are visits based on discipline or all therapies combined
- Use all of the visits the patient has to maximize their insurance coverage
- Encourage the patient to skip therapy outside of the clinic setting to save visits
- None – you can always ask for more visits
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Question 4 of 5

4. Question
What is a co-insurance?
- A fixed amount the patient pays for a covered service after meeting their deductible
- A percentage of the cost the patient pays after they have met their deductible
- The amount a patient pays before insurance coverage starts
- A fee that only applies to out-of-network services
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Question 5 of 5

5. Question
Why is it important to explain visit limitations to patients?
- To encourage them to use all their visits as quickly as possible
- To minimize the number of therapy sessions required
- To involve them in planning their therapy strategy and optimize visit usage
- To avoid discussing insurance coverage with patients to prevent confusion
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1.4 Health Insurance Terms - Student

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