Health quiz 2 B
The type of health care provider that provides both the health care services and the health care coverage is a
(HMO) Health Maintenance Organization
The characteristics of HMO'S include all of the following except
Patients may go directly to specialist if they cant get an appointment with their PCP
An HMO's contracting physicians are paid employees working on the staff of the HMO, operating in a clinic setting at the HMO's physical facilities. The HMO operates as a
Staff model HMO
when a HMO chooses a limited number of health care providers to provide services to its subscribers, this is known as
a closed panel
A method of payment in which a provider is paid a specific fee monthly for each subscriber is known as
capitation
The HMO concept when service providers are paid a fixed monthly fee for each member called
capitation
Gwen's HMO requires that she receive health care services from specified, limited number of health care providers chosen by the HMO, Gwen's HMO is
closed panel
The usual payment arrangement under a Preferred Provider Organization contract is
fee for service
A PPO will generally pay
full benefits for services rendered by a preferred provider, and a reduced amount if an individual uses a non preferred provider
All of following are examples of managed care plans except
indemnity arrangements
PPOs and HMOs are often called organizations because of their focus on efficient, cost-efficient plan administration
managed crew
HMO's are required to provide for all of the following except
prescription drugs
Those covered by an HMO are called
subscribers
In HMO, the use of a primary care physician or PCP is common as part of
the gatekeeper