BCBS corporations offer several federally designed and regulated Medicare supplemental plans that augment the Medicare program by paying for Medicare deductibles and copayments. These plans are usually identified by the word __________ on the patient's plan ID card.
a. Medicaid
b. Medicare
c. Medigap
d. MediSupp
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Q. 2) FEP cards contain the phrase __________ under the BCBS trademark.
a. BCBS Supplemental Plan
b. Federal Employee Program
c. Government-Wide Service Benefit Plan
d. Healthcare Anywhere
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Q. 3) The BlueCross BlueShield Federal Employee Program (FEP) is a(n) __________ health benefits program established by an Act of Congress in 1959.
a. employer-sponsored
b. government-sponsored
c. payer-sponsored
d. state-sponsored
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Q. 4) BCBS has a mandatory second surgical opinion (SSO) requirement necessary when a patient is considering elective, nonemergency surgical care. The initial surgical recommendation must be made by a physician qualified to perform the anticipated surgery. If a second surgical opinion is not obtained prior to surgery, the patient's out-of-pocket expenses may be __________.
a. eliminated
b. increased
c. reduced
d. waived
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Q. 5) The BCBS PPO plan is sometimes described as a subscriber-driven program, and BCBS substitutes the term subscriber or __________ for policyholder.
a. member
b. patient
c. payer
d. provider
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Q. 6) The BCBS outpatient pretreatment authorization plan (OPAP) requires preauthorization of outpatient physical, occupational, and speech therapy services. Other terms for OPAP include precertification and __________ authorization.
a. point-of-service
b. preferred
c. prospective
d. retrospective
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Q. 7) The BCBS coordinated home health and hospice care program allows patients with this option to elect an alternative to __________ or long-term care settings.
a. acute
b. emergency
c. outpatient
d. rehabilitation
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Q. 8) BCBS indemnity coverage offers choice and flexibility to subscribers who want to receive a full range of benefits along with the __________.
a. freedom to use any licensed health care provider
b. option to use network-based health care providers
c. requirement of obtaining referrals to providers
d. restriction of selecting a primary care provider
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Q. 9) The medical emergency care rider covers __________ treatment sought and received for sudden, severe, and unexpected conditions that if not treated would place the patient's health in permanent jeopardy or cause permanent impairment or dysfunction of an organ or body part.
a. continuous
b. immediate
c. protracted
d. recurring
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Q. 10) The BCBS special accidental injury rider covers nonsurgical care sought and rendered within 24 to 72 hours of the accidental injury, depending on plan benefits. Surgical care is subject to any established contract __________ plan deductibles and copayments.
a. basic
b. major medical
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