Question

Match the term or concept on the left with its description or definition on the right.
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-       A.       B.       C.       D.       E.       F.       G.       H.       I.       J.    Diagnosis related group       -       A.       B.       C.       D.       E.       F.       G.       H.       I.       J.    Fee for service       -       A.       B.       C.       D.       E.       F.       G.       H.       I.       J.    Risk spreading       -       A.       B.       C.       D.       E.       F.       G.       H.       I.       J.    Risk selection       -       A.       B.       C.       D.       E.       F.       G.       H.       I.       J.    Adverse selection

A. A medical provider is paid a fixed amount based on the patient's diagnosis. B. More individuals with a relatively high risk of disease purchase health insurance. C. A medical report or exam is required before purchasing a health insurance policy. D. Insurance company tries to encourage healthy policy holders and discourage or exclude customers with known medical conditions. E. Some medical conditions are excluded from a health insurance policy. F. A medical provider receives one payment per year for treating a patient with a particular medical condition. G. Higher risks of disease increase the cost of an insurance policy. H. Patients with the same disease and circumstances should incur the same medical treatment expenses. I. Each medical service carried out is reimbursed. J. Individuals in a group pay an average fee to an insurance company and the company covers the expenses of each.

0.5 points   

Answer 1

●The diagnosis related group receives the insurance based on the medical diagnosis

Ans:Patient with same disease and circumstances should receive the same treatment

●Fee for service is a way to collect fees based on the number or the quantity is service provided rather than the quality in patient care.In simple eachbsercices provided by a provider is p as I'd by the insurance company

Ans:Each medical service carried out is reimbursed

●Risk spreading refers to sharing the insurance with more than one insurance company or the policy holders ,because even if one or the other company or policy holder losses there won't be any major loss to the head.

Ans:Individual in a group pay an average fee to an insurance company and the company covers the expenses of each

●Risk selection in simple refers to selection based on people who are sick or may worsening

Ans:Insurance company tries to enroll healthy policyholders and discourage or exclude customers with known medical conditions

●Adverse selection refers to the insurance is bought by high risk people here the healthy people sinus purchaser

Ans:More individuals with relatively high risk of disease purchase the health insurance