5 Written Questions
5 Matching Questions
- Primary Care Providers (PCP):
- Point-of-Service Plan (POS):
- What year First Blue Cross policy started:
- Health Maintenance Organization (HMO):
- a 1929
- b amount for which the patient is financially responsible before insurance policy provides coverage
- c is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
- d responsible for providing healthcare services to subscribers in a given geographical area for a fixed fee.
- e patients are free to use the managed care panel of providers or self-refer to non-managed care providers
5 Multiple Choice Questions
- providing essential healthcare services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists.
- organization of affiliated providers' sites that offer joint healthcare services to subscribers
- a classification system used to collect data for statistical purposes
- contracted network of healthcare providers that provide care to subscribers for a discounted fee.
- by American Medical Association in 1966
5 True/False Questions
First Blue Cross policy: → introduced a plan to guarantee school teachers 21 days of hospital care for 46 a year.
Discharge planning: → arranging appropriate healthcare services for discharged patients.
Occupational Safety & Health Administration Act (OSHA): → 1970
Preauthorization: → prior approval
Preferred providers: → review for medical necessity of tests/procedures ordered during inpatient hospitalization