5 Written questions
5 Matching questions
- Tertiary care
- Patient Information Letter
- Physician Provider Group (PPG)
- 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).
- b Transfer the sickest high-cost patients to other physicians so that the provider appears as a low utilizer
- c Physician owned business that has the flexibility to deal with all forms of contract medicine and offers its own packages to business groups, unions and the general public.
- d - National Committee for Quality Assurance, accredits HMOs.
- e Referral of a patient recommended by one specialist to another specialist.
5 Multiple choice questions
- Physician informs the patient and telephones the referring physician that the patient is being referred for an appointment.
- - Patient services are more than absorbed amount physician can begin asking to paid.
- Patient's services are more than certain amount, the physician can begin asking the patient to pay (fee-for-service)
- - Point-of-service Option or Plan
- Card given to each enrollee of a managed care plan include and list patient's the name and member number
- The patient refers himself or herself to a specialist, the patient may be required to inform the primary care physician.
5 True/False questions
Indemnity Plan → Traditional insurance; insured pays monthly premiums and 100% of medical bills until deductible is met.
MCO → - Health Maintenance Organization.
QIO → - Quality Improvement Organization
IPA → - Independent (or Individual) Practice Association.
EPO → - Preferred Provider Organization