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54 terms

LOM week 2 skill learning

STUDY
PLAY
The shaft of a long bone is called the
diaphysis
The strong membrane surrounding the surface of a bone is the
periosteum
Hard, dense bone tissue lying under the periosteum is called
compact cortical
finger bones
phalanges
foot bones
metatarsals
backbone
vertebra
-asthenia
lack of strength
-desis
bind, tie together
-plasty
surgical repair
sub-
under; below
Incision of a joint
arthrotomy
Tumor (malignant) of cartilage
chondrocacroma
Inflammation of a sac of fluid near a joint
bursitis
Lateral curvature of the spine
scoliosis
acetabulum
ta
fibromyalgia
al
cartilage
consecutive tissues at joints
condyle
rounded process at the joint
tubercle
rounded attachment of tendons and muscles
trochanter
large process on the femur for attachment of tendons and muscles
pyrexia
fever
olecranon
elbow bone
osteogenic sarcoma
common malignant tumor from osteoblasts
leiomyosarcoma
malignant tumor of smooth muscle
muscular dystrophy
weak muscles
malleol/o
process on each side of the ankle, process on each side of the ankle
metacarp/o
metacarpals (hand bones)
phalang/o
finger and toe bones
vertebr/o
vertebra (backbone)
America's oldest privately owned, prepaid medical group is
A. Ross-Loos Medical Group
What plan allows members of Kaiser permanente Medical Care program to seek medical help from non-Kaiser physicians?
B. POS
Kaiser Permenente's medical plan is a closed panel program, which means
it limits the patients choice of personal physicians
How are physicians paid who work for a prepaid group practice model?
Salary paid by independent group
What is the name of an organization of physicians sponsored by a state or local medical association that is concerned with the development and delivery of medical services and the cost of health care?
Foundation for medical care
An organization that gives members freedom of choice among physicians and hospitals and provides a higher level of benefits if the providers listed on the plan are used is called a
PPO
A physician-owned business that has the flexibility to deal with all forms of contract medicine and also offers its own plans is a
PPG
Practitioners in an HMO program my come under peer review by a professional group called
quality improvement organization QIO
Referral of a patient recommended by one specialist to another specialist is known as
tertiary care
What is the correct procedure to collect a copayment on a managed care plan?
Collect the copayment when the patient arrives for the office visit.
The abbreviation MCO stands for
Managed Care Organization
Benefits under the HMO Act fall under two categories______________ health services and supplemental health services.
Basic
UR is the abbreviation for _____ ________ which is necessary to control costs in the health care setting.
utilization review
When a managed care plan requires the primary care physician to seek approval before referring a patient to a specialist, it is called obtaining
preauthorization
When a certain percentage of the monthly capitation payment is held out of the premium fund to pay for operating an IPA, it is know as a
withhold
Ross-Loos Medical Group, America's oldest privately owned prepaid medical group, started in Texas.
False
The Health Maintenance organization Act of 1973 required most employers to offer HMO coverage to their employees as an alternative to traditional health insurance.
True
Medicare-eligible patients are involved with HMO's or prepaid health plans
False
In a staff model HMO, physicians are hired directly by the health plan that pays their salary.
True
Exclusive provider organizations EPO's are regulated by the federal government
False
The difference between an IPA and a PPG is that a PPG may not be owned by its member physicians, whereas an IPA is physician owned.
False
If a primary care physician sends a patient to a specialist for consultation who is not in the managed care plan, the specialist may bill the primary care physician for payment.
True
Managed care plans never require a CMS-1500 claim form to be completed and submitted
False
Usually, there are no deductibles for managed care plans.
True
A copayment in a managed care plan is usually a fixed dollar amount (predetermined fee).
true