5 Written Questions
5 Matching Questions
- Ross-Loos Medical Group
- Patient Information Letter
- Indemnity Plan
- 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 Traditional insurance; insured pays monthly premiums and 100% of medical bills until deductible is met.
- c - Health Plan Employer Data Information Set
- d 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.
- e - America's oldest privately owned prepaid medical group.
5 Multiple Choice Questions
- Utilization Review
- - Consolidated Omnibus Budget Reconciliation Act
- A requirement of some health care plans to obtain permission for a service or procedure before it is done and to see whether the insurance program agrees it is medically necessary.
- An authorization request form is completed and signed by the physician and handed to the patient.
- Managed Care Organizations
5 True/False Questions
POS → - Point-of-service Option or Plan
Tertiary care → - Employee Retirement Income Security Act
Case Rate Pricing → The specialist contracts with the managed care plan for an entire episode of care.
Correct procedure to collect a co-payment on a MCPlan → Is a physician who controls patient access to specialists and diagnostic testing services.
Withhold → - Health Maintenance Organization.