Explain what is common and difference between a precertification, referrals and preauthorization. (4pts) 6. Explain what is the purpose of the utilization management and utilization review committee (2pts) 7. In your own words, define the following health insurance plans. Please include who does the insurance plans cover. (5pts) a. Worker’s Compensation b. TriCare c. Civilian Health and Medical Program of the Veterans Administration d. CHIP e. Medicaid 8. What does abbreviations stand for and define the term in your own words? (2pts) QMB b. UCR EOB d. RBRVS 9. When setting up a fee schedule what three factors are considered? (1.5pts) 10. What program will a MA use to verify, insurance eligibility, benefits, and exclusion prior to a patient’s appointment? (1pt) 11. In your own words, describe 4 other types of insurance. (4pts) a. C.
