Match the Following -The Amount That a Policyholder Must Pay for Covered Services

question 78

Multiple Choice

Match the following

-The amount that a policyholder must pay for covered services before insurance benefits begin to pay

• A) deductible
• B) electronic remittance advice (ERA)
• C) conversion factor
• D) coinsurance
• E) relative value unit
• F) reason code
• G) adjudication
• H) copayment
• I) withhold
• J) allowed charge

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Definitions:

Evaluate The Action

The process of examining and assessing the effectiveness and outcomes of an action or intervention to determine its value or impact.

Clinical Judgment Model

A model that includes four aspects that can be used within continuously evolving practice environments: noticing, interpreting, responding, and reflection.

Alfaro-LeFevre's Model

A critical thinking framework developed by Rosalinda Alfaro-LeFevre that emphasizes the importance of clinical reasoning in nursing practice.

Theoretical Knowledge

Conceptual understanding of principles and ideas that form the foundation of a subject or area of study.