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