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5 Written Questions

5 Matching Questions

  1. Primary Care Providers (PCP):
  2. Point-of-Service Plan (POS):
  3. What year First Blue Cross policy started:
  4. Deductible:
  5. Health Maintenance Organization (HMO):
  1. a 1929
  2. b amount for which the patient is financially responsible before insurance policy provides coverage
  3. c is responsible for supervising & coordinating healthcare services for enrollees & approves referrals to specialists & inpatient hospital admissions (except in emergencies)
  4. d responsible for providing healthcare services to subscribers in a given geographical area for a fixed fee.
  5. e patients are free to use the managed care panel of providers or self-refer to non-managed care providers

5 Multiple Choice Questions

  1. providing essential healthcare services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists.
  2. organization of affiliated providers' sites that offer joint healthcare services to subscribers
  3. a classification system used to collect data for statistical purposes
  4. contracted network of healthcare providers that provide care to subscribers for a discounted fee.
  5. by American Medical Association in 1966

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. Discharge planning:arranging appropriate healthcare services for discharged patients.

          

  3. Occupational Safety & Health Administration Act (OSHA):1970

          

  4. Preauthorization:prior approval

          

  5. Preferred providers:review for medical necessity of tests/procedures ordered during inpatient hospitalization

          

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