Unit 2.2 Review Insurance plans

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Which one of the following types of insurance plans pays providers per patient, per month?

EPO, HMO, PPO, POS

In UCR fees, the portion that's based on what doctors with similar training charge in a specific area is known as the ---------- fee.

customary

Legislation that mandated the use of electronic health records was called

HITECH

Legislation that made health insurance available to everyone was called

ACA

You're a medical office specialist who just asked a patient if she has health insurance. What is probably your next step?

Ask to see the patient's ID card.

Which one of the following choices is an important reason for medical office specialists to understand the history of healthcare in America?

It will help them better communicate with patients.

Which managed care plan offers freedom of choice to the patient?

PPO

If negotiated managed care fees are too low for a capitated payment, how could a physician make up the difference in payments?

See more patients.

Reimbursement based on a fixed payment per patient per month is called

capitation

Delivering high-quality care that manages costs is a goal of

managed care

A network of hospitals and physicians that join together to negotiate with insurance companies and employers is called a/an

physician-hospital organization


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