Question 1
HMO has a team of providers in the net work which doesn't allow to select the provider of choice bybthe patient.It offers a low premium
PPO is a scheme where patient can select any provider as per their wish in the network . They don't want a referral from a primary care provider.Here the providers healthcare organization have a tie up with the insurance company to provide a low cost service to patients.It has two deductibles one to in net work provider and if service is rendered from out of network a separate chaff will be laid.It is less in co pay part.
POS is a combination of HMO and PPO where patient can select the physician of their choice .They have to pay high if opts for a out of network provider without a referral.
HSA is a high deductible plan to the population
Ans:Preferred provider organization
QUESTION 1 contain costs while retaining the patient's choice of physician while following the fee-for-service type...
Discuss the advantages and disadvantages to Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Fee-for-Service (FFS) insurance plans. Of these three insurance plans, which one would you prefer to have and why?
4. KEY TERMS Multiple Choice Circle the letter of the choice that best matches the definition or answers the question 1. A list of the medical services covered by an insurance policy C. Noncovered services D. Fee-for-service A. Health care claim B. Schedule of benefits 2. Health plans are often referred to as: C. Providers D. Payers A. Policyholders B. Subscribers managed care network of providers under contract to provide services at discounted fees. A. Health Maintenance Organization (HMO) B....
Comparing Private Insurance P Alison purchases health insurance coverage for herself and her spouse. This is an example of a group urance plan Indemnity, or fee-for-service, plans and managed care plans cover medical expenses if you are sick or injured, but in different ways. The following questions examine the general differences between the two plans. Taking a closer look at how these plans provide coverage will help you begin to customize a health care plan that best suits your requirements....
Question 8 1 pts Discharge planning is associated with which type of utilization review? (Level 2) a. Concurrent b. Prospective c. Gatekeeping d. Retrospective 1 pts Question 7 1 pts In which of the following plans can an MCO lose a large number of physicians if a contract is lost? (Level 1) a. POS plans b. PPO plans c. HMO group model plans d. HMO IPA model plans e. None of the above D Question 5 1 pts According to...
Question 16 1.33 pts According to Chapter 10, there were 32,000 assisted living facilities and similar facilities, 12,400 home health agencies, 4,800 adult day care centers, and 4,000 hospices in the U.S. Based upon this information, is the ratio between assisted living facilities to hospices a greater ratio than the ratio between adult day care centers and home health agencies? (Level 3) O a. Yes, the ratio between assisted living facilities and hospices 4:1 is greater than the ratio 31:...
69) A policy that pays you back for actual expenses is called A) An indemnity plan. B) A deductible plan. C) A reasonable and customary plan. D) A reimbursement plan. E) A coinsurance plan m The set amount that you must pay toward medical expenses before the insurance company pays benefits is called A) Deductible. B) Reimbursement C) Indemnity. D) Internal limit. E) Reasonable and customary charges. 71) Which of the following is a government health care program? A) Health...
Some common liability risks include: Question 16 options: 1) driving a car. 2) Entertaining guests at home. 3) being careless in performing professional duties. 4) all of the above 5) none of the above Question 17 (0.5 points) Which of the following types of plans pay for some medical costs even when the insured decides to go out of the provider network (without a referral) for services? Question 17 options: 1) HMO 2) IPA 3) PPO 4) POS 5) c...
help pleaas HSA 4170 Exam 2 Study Guide-80 Questions Chapter 4: 1. At ABC company, if assets equal $50,000 and liabilities equal $30,000, what is the total of liabilities and net worth? A) $20,000 B) $50,000 C) $70,000 D) None of these is correct 2. At XYZ corporation, amount? etaned earnings are $10.000 and labases are $25,000, what is the total asset A) $35,000 B) $50,000 C) An unknown figure D) None of these is correct 3. At the General...
1) The most common approach to health and healthcare in America is A) Reactive Health Approach B) Proactive Health Approach C) Health Promotion Approach D) Health Maintenance Approach 2) The Proactive Health Approach is A) treatment oriented. B) more costly than reactive health. C) prevention oriented. D) highly promoted by the insurance industry 3) The Reactive Health Approach is A) prevention oriented. B) leads to a high degree of health and wellness. C) less costly than proactive health. D) treatment...
1.33 pts Question 9 When Charlotte's ACL was torn, she visited her physician at an outpatient care facility. Her doctor's decision to not recommend surgery for Charlotte and 10 other patients with similar conditions is under review by the Board of the outpatient facility. Charlotte and other patients complained that they still struggled to walk after the recovery period. What type of utilization review would identify this delivery of service? (Level 3) Oa. Prospective Utilization Review (the doctor used this...