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5 Written Questions

5 Matching Questions

  1. IPA
  2. Indemnity Plan
  3. Patient Information Letter
  4. PPO
  5. Identification Card
  1. a - Inform managed care subscriber in writing what is expected from them and what they can expect in turn.

    - Also known as Waiver of Liability in Medicare program is called Advance Beneficiary Notice (ABN).
  2. b - Independent (or Individual) Practice Association.
  3. c - Preferred Provider Organization
  4. d Card given to each enrollee of a managed care plan include and list patient's the name and member number
  5. e Traditional insurance; insured pays monthly premiums and 100% of medical bills until deductible is met.

5 Multiple Choice Questions

  1. - Consolidated Omnibus Budget Reconciliation Act
  2. - Quality Improvement Organization
  3. - America's oldest privately owned prepaid medical group.
  4. Is the largest pioneer in private insurance company in the United States.
  5. An authorization request form is completed and signed by the physician and handed to the patient.

5 True/False Questions

  1. Silent PPO Plan- Plans purchase by existing PPOs without notifying providers who have signed contracts.

    - Also known as Silent, Blind, or Phantom PPOs, Discounted Indemnity plans, Nondirected PPOs, or Wraparound PPOs.


  2. Tertiary careReferral of a patient recommended by one specialist to another specialist.


  3. Withhold- Health Maintenance Organization.


  4. TurfingWhen physician see a high volume of patient more than medical necessary to create revenue. May be seen in fee-service or managed care environment.


  5. Case Rate PricingThe specialist contracts with the managed care plan for an entire episode of care.


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