Defining should include the following terms:
- Eligibility effective date
- Termination of coverage
- Preauthorization
- Precertification
- Preauthorization form
- Authorized treatment record form
- Basic benefits
- Accident benefits
- Preadmission testing
- Second surgical opinion
- Outpatient facility charges
- Coordination of benefits
- Order of benefits
- Inpatient facility charges
- Advanced Beneficiary Notice (ABN)
Process/Skill Questions
- Why is the preauthorization of medical procedures sometimes necessary?
- How do accident benefits vary from basic benefits with regard to payment?
- Who initiates second surgical opinions?
- What is the difference between outpatient and inpatient facility charges?