Chapter 3 Sports Med II

Question 1

The primary care Dr. assigned by the insurer who oversees the medical care rendered to patients

Accepted Answer

Gate Keeper

Question 2

A person eligible to receive the benefits of a specific policy or program

Accepted Answer

Beneficiary

Question 3

3rd party reimbursement is the primary mechanism of payment for medical services in the US

Accepted Answer

True

Question 4

A legal wrong

Accepted Answer

Tort

Question 5

A ins report accompanying all claim payments that explain how the ins company processed a claim

Accepted Answer

Explanation of benefits

Question 6

When an athlete assumes the risk of that sport that means they cannot sue for any accidents

Accepted Answer

False

Question 7

Prof. liability ins typically covers in civil cases, but not if a criminal complaint is filed

Accepted Answer

True

Question 8

An athlete not covered by family health must purchases school insurance

Accepted Answer

True

Question 9

An athlete sprains ankle during soccer. If the AT fails to provide care he/she is negligent

Accepted Answer

True

Question 10

Most traditional form of billing for healthcare

Accepted Answer

Fee for service

Question 11

Results in unreasonable risk of harm to others

Accepted Answer

Negligence

Question 12

A legal binding agreement between an ins company and a dr describing duties of both parties

Accepted Answer

Contract

Question 13

A specific amount paid by the policy holder

Accepted Answer

Co-payment

Question 14

Written guarantee that athletic equipment is safe

Accepted Answer

Product liability

Question 15

Neither the gov. or any indiv. who is employed by the gov. can be held liable for negligence

Accepted Answer

Sovereign immunity

Question 16

Third party reimbursement is the primary mechanism of payment for services in the US

Accepted Answer

True

Question 17

A combination of both a PPO and HMO

Accepted Answer

Point of service plan

Question 18

Treatment not covered by insurance policy

Accepted Answer

Exclusions

Question 19

A form sent to an insurance company requesting payment for covered medial expenses

Accepted Answer

Claim

Question 20

A person legally eligible for benefits based on his or her relationship with the policyholder

Accepted Answer

Dependent

Question 21

Services that an insurer, a gov. agency, or healthcare plan offers to pay for the individual

Accepted Answer

Benefits

Question 22

If an AT modifies a piece of equipment and the athlete sustains an injury the trainer is liable

Accepted Answer

True

Question 23

The state of being legally responsible for the harm one caused another person

Accepted Answer

Liability

Question 24

A healthcare provider in contract with an insurance provider to the beneficiaries of a plan

Accepted Answer

Participating Provider

Question 25

A periodic payment made to an ins company by an individual policy holder

Accepted Answer

Premium

Question 26

The max amount the insurance will pay for each procedure or service

Accepted Answer

Allowable charge

Question 27

Acknowledgement of hazards in sports

Accepted Answer

Assumption of risk

Question 28

The person who takes out the medical insurance policy

Accepted Answer

Policy holder

Question 29

Part of an official of description

Accepted Answer

Duty of Care

Question 30

An individual improperly commits an act that is not legally his or hers to perform.

Accepted Answer

Malfeasance

Question 31

A specific length of time in which an individual may sue

Accepted Answer

Statue of limitations

Question 32

Provides limited protection against legal liability to any person that chooses to do first aid

Accepted Answer

Good Samaritan Law

Question 33

When an individual fails to perform a legal duty

Accepted Answer

nonfeasance

Question 34

Members make monthly payment

Accepted Answer

Capitation

Question 35

Manufactures of products do not have a duty to design and produce equip that will not cause inj

Accepted Answer

False

Question 36

According to NOCSAE all FB helmets must have a warning label informing athlete of all risks

Accepted Answer

True

Question 37

Owed by insured annually before the insurance company will pay.

Accepted Answer

Deductible

Question 38

An individual improperly does something he/she has the legal right to do

Accepted Answer

Misfeasance

Chapter 3 Sports Med II

Questions 38

Chapter 3 Sports Med II

Questions 38