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5 Written questions

5 Matching questions

  1. Verbal referral
  2. ERISA
  3. Tertiary care
  4. Correct procedure to collect a co-payment on a MCPlan
  5. Verbal Referral
  1. a Physician informs the patient and telephones the referring physician that the patient is being referred for an appointment.
  2. b - Employee Retirement Income Security Act
  3. c Referral of a patient recommended by one specialist to another specialist.
  4. d At the time service is rendered.
  5. e Primary care physician informs the patient and phones the referring physician that the patient is being referred for an appointment.

5 Multiple choice questions

  1. The specialist contracts with the managed care plan for an entire episode of care.
  2. Managed Care Organizations
  3. The patient refers himself or herself to a specialist, the patient may be required to inform the primary care physician.
  4. Is a physician who controls patient access to specialists and diagnostic testing services.
  5. Is the largest pioneer in private insurance company in the United States.

5 True/False questions

  1. MCO- Quality Improvement Organization

          

  2. IPA- Exclusive Provider Organization.

          

  3. Physician Provider Group (PPG)- A process based on established criteria, of reviewing and controlling the medical necessity for services and providers use of medical care resources.

    - Known as Utilization or Management Control.

          

  4. QIOManaged Care Organizations

          

  5. Triple OptionPlan that allows members to select from three choices; HMOs, PPOs, or "Traditional" indemnity insurance.