10+ Imaginnovate Interview Questions and Answers

Types of denial include simple denial, minimization, projection, and inclusive denial.

• Simple denial is refusing to acknowledge the reality of a situation.

• Minimization is downplaying the significance of a situation.

• Projection is attributing one's own thoughts or feelings to someone else.

• Inclusive denial involves a group of people collectively denying a reality or truth.

Auth is short for authentication, the process of verifying the identity of a user or system.

• Auth is required to ensure that only authorized users have access to sensitive information or resources.

• It helps prevent unauthorized access and protects against security threats.

• Common methods of authentication include passwords, biometrics, and two-factor authentication.

• For example, when you log into your email account, you are required to enter a username and password to authenticat...read more

Types of claim forms include health insurance claim forms, auto insurance claim forms, and property insurance claim forms.

• Health insurance claim forms

• Auto insurance claim forms

• Property insurance claim forms

OON stands for Out of Network, referring to healthcare providers that do not have a contract with a particular health insurance plan.

• Healthcare providers who are OON may result in higher out-of-pocket costs for patients

• Patients may need to pay the full cost of services upfront and then seek reimbursement from their insurance company

• Some insurance plans may not cover any services provided by OON providers

An out of network provider is a healthcare provider that does not have a contract with a particular health insurance plan.

• Out of network providers may result in higher out-of-pocket costs for patients.

• Patients may need to submit claims themselves when using out of network providers.

• Some health insurance plans may cover out of network providers at a lower rate.

• Patients should always check with their insurance plan to understand coverage for out of network providers.

Prior authorization is a process used by insurance companies to determine if they will cover a specific medication, procedure, or service before it is provided.

• Prior authorization is a requirement by insurance companies to approve coverage for certain medications, procedures, or services.

• It involves submitting a request to the insurance company with supporting documentation from the healthcare provider.

• The insurance company reviews the request to determine if the treatment is...read more

Non cover charges refer to fees or costs that are not included in the initial price or quote.

• Non cover charges are additional fees that may be incurred on top of the base price.

• These charges are typically not disclosed upfront and may come as a surprise to the customer.

• Examples of non cover charges include service fees, taxes, gratuity, and processing fees.

Medical necessity refers to the criteria that must be met for a medical service or procedure to be deemed appropriate and essential for a patient's health.

• Medical necessity is determined by evaluating the patient's condition and the expected outcome of the treatment.

• It is often based on evidence-based guidelines and clinical judgment.

• Insurance companies use medical necessity criteria to determine coverage for services.

• Examples include a surgery being necessary to save a patie...read more

Medicare and Medicaid are government-sponsored healthcare programs in the United States.

• Medicare is a federal health insurance program primarily for individuals aged 65 and older, as well as younger people with certain disabilities.

• Medicaid is a joint federal and state program that helps with medical costs for people with limited income and resources.

• Medicare is divided into different parts, such as Part A (hospital insurance) and Part B (medical insurance), while Medicaid be...read more

Inclusive denial is the act of denying someone access or participation in a group or activity based on their identity or characteristics.

• Inclusive denial can occur in various settings such as workplaces, schools, or social groups.

• It often involves excluding individuals based on factors like race, gender, sexual orientation, or disability.

• Examples include refusing to hire someone because of their ethnicity or not allowing a person to join a club because of their sexual orienta...read more

HMO focuses on primary care physicians and requires referrals for specialists, while PPO offers more flexibility in choosing healthcare providers.

• HMO requires members to select a primary care physician (PCP) who coordinates all of their healthcare needs.

• HMO members need referrals from their PCP to see specialists.

• PPO allows members to see any healthcare provider without a referral, but offers lower coverage for out-of-network providers.

• PPO typically has higher premiums and de...read more