5 Written Questions
5 Matching Questions
- Indemnity Plan
- Patient Information Letter
- Identification Card
- 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 - Independent (or Individual) Practice Association.
- c - Preferred Provider Organization
- d Card given to each enrollee of a managed care plan include and list patient's the name and member number
- e Traditional insurance; insured pays monthly premiums and 100% of medical bills until deductible is met.
5 Multiple Choice Questions
- - Consolidated Omnibus Budget Reconciliation Act
- - Quality Improvement Organization
- - America's oldest privately owned prepaid medical group.
- Is the largest pioneer in private insurance company in the United States.
- An authorization request form is completed and signed by the physician and handed to the patient.
5 True/False Questions
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.
Tertiary care → Referral of a patient recommended by one specialist to another specialist.
Withhold → - Health Maintenance Organization.
Turfing → When physician see a high volume of patient more than medical necessary to create revenue. May be seen in fee-service or managed care environment.
Case Rate Pricing → The specialist contracts with the managed care plan for an entire episode of care.