GNF Finance Quiz

Generate an informative and engaging illustration depicting various aspects of health insurance coverage for fertility treatments, including symbols for IVF, embryo banking, and medical necessity. Use a professional and educational tone in the image.

GNF Finance Quiz: Test Your Knowledge on Insurance Coverage

Welcome to the GNF Finance Quiz! This quiz is designed to challenge your understanding of insurance policies related to infertility treatments. Dive in and discover how well you know the critical details that can impact patient care and treatment options.

In this quiz, you will learn about:

Prior Authorizations
Insurance coverage for fertility treatments
Definitions of infertility and associated terms

22 Questions6 MinutesCreated by SearchingCloud457

What is a Prior Authorization, Pre-certification, or Pre-Approval?

A decision by a health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

A verification of infertility coverage

A decision by a provider to recommend services

Which clinical information should you submit to insurance for prior authorization? Select all that apply

If above the age of 35, patients must try for at least __ months to meet the definition of infertility

4 Months

12 Months

9 Months

6 Months

What is the estimated turnaround time for a response from the insurance once a prior authorization is submitted?

What is a Lifetime Maximum?

The maximum dollar amount a health plan will pay in benefits to an insured individual during that individual's lifetime.

The amount you pay for covered health care services before your insurance plan starts to pay

He percentage of costs of a covered health care service you pay after you've paid your deductible.

The most you have to pay for covered services in a plan year.

What is Medical Necessity?

An indication created by health insurance companies to determine “medically necessary” procedures and interventions.

Legal entitlement to payment or reimbursement for your health care costs, generally under a contract with a health insurance company, a group health plan

The process your health insurance company uses to review how necessary a medical treatment or medication may be in treating your condition.

When is PGT-A covered by insurance? Select all that apply:

3 Failed IVF cycles

History of Trisomy

Pt/Part are both carriers for the same genetic disease

A coinsurance is the percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

True

False

An out of pocket maximum is the most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits

True

False

Sally has Aetna insurance with 3 frozen embryos in storage. Sally wishes to complete another IVF cycle. Will her insurance cover her next cycle?

No, Aetna will require her to transfer all frozen embryos in storage before authorizing another IVF cycle.

Yes, Sally has coverage for IVF and her insurance will cover another IVF cycle.

Yes, Aetna allows Embryo Banking

No, the patient will have to pay out of pocket for her next IVF cycle. Aetna will not cover.

Egg Freezing is considered an elective procedure unless the following criteria is met. Select all that apply:

Cancer Diagnosis

Medical treatment would directly or indirectly cause iatrogenic infertility

Preventative measure for specific medical conditions

Family Balancing

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GNF Finance Quiz: Test Your Knowledge on Insurance Coverage

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