Asked by
Ladarrius Giles
on Oct 07, 2024
Verified
Approval obtained before the patient is admitted to the hospital or receives specified outpatient or in-office procedures
A) managed care
B) Medicaid
C) precertification
D) preexisting condition
E) service area
F) subscriber
G) individual insurance
H) indemnity plan
I) utilization management (review)
J) workers' compensation
Precertification
Refers to obtaining plan approval for services prior to the patient receiving them; refers to seeking approval for a treatment (surgery, hospitalization, diagnostic test) under the patient’s insurance contract.
Specified Outpatient
Specified Outpatient refers to particular outpatient medical treatments or procedures that are predefined under a health plan or policy for coverage or reimbursement.
- Interpret the significances and operations of various health insurance terms and policies.
- Comprehend the process and importance of precertification, preauthorization, and predetermination in health care.
Verified Answer
JS
Learning Objectives
- Interpret the significances and operations of various health insurance terms and policies.
- Comprehend the process and importance of precertification, preauthorization, and predetermination in health care.