Question

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. Preferred Provider Organization (PPO) C. Point-of-Service Plan (POS) D. Open-access plan 4. A fixed prepayment made to a medical provider for all necessary, contracted services provided to each patient who is a plan member for a specific period. A. Capitation С. Participation D. Payer B. Benefit A health plan that reimburses based on the fees charged. A. Indemnity 5. . Managed care D. Disability B. PPO An amount that a health plan requires a beneficiary to pay at the time 6. of service for each health care encounter. A. Deductible B. Copayment C. Coinsurance D. Fee-for-service

Answer 1

Ans:- 1. B

Schedule of benefits

A list of the medical services covered by an insurance policy that is scheduled of benefits.

2. D

Payers,

Health plans are often referred as payers.

3. B,

Preferred provider organization (ppo)

A managed care network of providers under contract to provider services at discounted fees is called preferred provider organization.

4. A

Capitation ,

A fixed prepayment made to a medical provider for all necessary, contracted services provided to each patient who is a plan member for a specific period is known as capitation.