Question

Match the following terms with their definitions (30pts) Certificate holder Certificate number Select One Claim that has a defect or impropriety Health condition, illness, injury, disease, or symptom for which the healthcare Insurance company will pay for treatment Member of a group for which the employer or association has purchased group healthcare Insurance Request for payment that contains only accurate information Specific service for which a healthcare insurance company will pay. Unique number identifying the holder of a healthcare Insurance policy. Covered condition Clean claim Select One Select One Dirty claim Covered service Select One TEATRE

Answer 1

●Certificate holder refers to the name of the person or organization which holds it

Ans:Member of a group for which employer of the group or association has purchased the group health plan

●A person or organization which has a unique or specific number allocated for the insurance taken this in simple contains the details of the insured person.

Ans:Unique number identifying the holder of health insurance policy

●Covered condition refers to the types of diseases which is covered and can ge provided treatment

Ans:Health condition,illness, injury, disease or symptoms for which the health insurance company will pay for treatment

●Clean claim in simple refers to no errors in a particular claim or document

Ans:Request for payment that contains only appropriate information

●Dirty claim usually refers to a claim which often has errors

Ans:Claim that has defect or impropriety

●Covered services generally describes any specific illness or service that can be paid by the health insurance company to the policy holder

Ans:Specific condition for which the health insurance company will pay