Medical Law and Ethics Third Edition (Chapter Four)

23 terms by likubles 

Create a new folder

Advertisement Upgrade to remove ads

This is for Medical Law and Ethics Proper Terms, and Spelling (Chapter by Chapter) Written by Bonnie F. Fremgen (Third Edition)

Health Maintenance Organization (HMO)

a type of managed care plan that offers a range of health services to plan members for a predetermined fee per member by a limited group of providers

Fixed-Payment Plan

a payment plan for medical bills that offers subscribers (members) complete medical care in return for a fixed monthly fee

Third-Party Payers

a party other than the patient who assumes responsibility for paying the patient's bills (for example, an insurance company)

Gatekeeper

the person, such as a primary care physician, or entity, such as an insurance company, that approves patient referrals to other physicians or services

Primary Care Physician (PCP)

HMO-designated physician to manage and control an enrolled patient's medical care

Managed Care Organization (MCO)

a type of medical plan that pays for and manages the medical care a patient receives

Capitation Rate

a fixed monthly fee paid by an HMO to health care providers for providing medical services to patients who are members of that HMO

Copayment

an agreed-upon fee paid by the insured for certain medical services; usually $10 to $20

Medicare

federal program that provides healthcare coverage for persons over 65 years of age as well as for disabled persons or those who suffer kidney disease or other debilitating ailments

Medicaid

federal program, implemented by the individual states, to provide financial assistance for the indigent

Indigent

a person who is without funds

Per Diem

daily rate (4)

Prospective Payment System

payment amount or reimbursement is known in advance

Diagnostic Related Groups (DRGs)

designations used to identify reimbursement per condition in a hospital; used for Medicare patients

Solo Practice

a medical practice in which the physician works alone

Sole Proprietorship

a type of medical practice in which one physician may employ other physicians

Partnership

a legal agreement in which two or more physicians share the business operation of a medical practice and become responsible for the actions of the other partners

Associate Practice

a legal agreement in which physicians agree to share a facility and staff but do not, as a rule, share responsibility for the legal actions of each other

Group Practice

three or more physicians who share the same facility and practice medicine together

Corporation

a type of medical practice, as established by law, that is managed by a board of directors

Franchise

a business run by an individual to whom a franchisor grants the exclusive right to market a product or service in a certain market area

Franchisees

persons or companies who hold a franchise

Conscience Clause

legislation or regulation stating that hospitals and healthcare professionals are not required to assist with such procedures as abortion and sterilization

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set