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5 Written questions

5 Matching questions

  1. Utilization review:
  2. Health Maintenance Organization (HMO):
  3. Subscriber:
  4. Preferred providers:
  5. Managed Care Organizations (MCO):
  1. a provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis
  2. b is responsible for the health of a group of enrollees & can be a health plan.
  3. c PPO
  4. d method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case
  5. e person in whose name the insurance policy is issued

5 Multiple choice questions

  1. providing essential healthcare services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists.
  2. S-Subjective
    O-Objective
    A-Assessment
    P-Plan
  3. coverage for catastrophic or prolonged illness & injuries
  4. the percentage the patient pays for covered services after the deductible has been met & the copayment has been paid
  5. 1860 by The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the US to provide private healthcare coverage for injuries not resulting in death.

5 True/False questions

  1. First Blue Cross policy:introduced a plan to guarantee school teachers 21 days of hospital care for 46 a year.

          

  2. Pre-admission review:method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case

          

  3. Concurrent review:method of controlled healthcare cost & quality of care by reviewing the appropriateness & necessity of care provided to patients prior administration of case

          

  4. Primary Care Providers (PCP):is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)

          

  5. Copayment:provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)

          

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