5 Written questions
5 Matching questions
- Preferred Provider Organization (PPO):
- SOAP stands for:
- Who developed ICD:
- a S-Subjective
- b contracted network of healthcare providers that provide care to subscribers for a discounted fee.
- c World Health Organization (WHO) in 1948
- d provider accepts preestablished payments for providing healthcare services to enrollness over a period of time (usually one year)
- e prospective payment system that reimburses hospitals for impatient stays
5 Multiple choice questions
- network of physicians & hospitals that have joined together to contract w/insurance companies, employers.
- by American Medical Association in 1966
- review for medical necessity of tests/procedures ordered during inpatient hospitalization
- a classification system used to collect data for statistical purposes
5 True/False questions
Primary Care Providers (PCP): → PPO
Clinical Laboratory Improvement Act (CLIA): → is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
Health Maintenance Organization (HMO): → 1973
Health Insurance Portability & Accountability Act of 1996 (HIPPA): → mandates regulations that govern privacy, security, & electronic transactions standards for healthcare information.
Gatekeeper: → person in whose name the insurance policy is issued