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Healthcare Management Organizations: Insurance Models, Medicare Coverage and Regulation

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Business - Insurance

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michael1tekrzp Created by 10 mon ago

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Cards in this deck(15)
The purpose of the nurse practice act is to determine the _____ of practice.
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An MCO receives a predetermined _____ payment for each client in the program.
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An HMO receives a prepaid fee to provide comprehensive care to members of a group and discourages physicians from ordering excessive _____ tests and treatments.
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If an HMO patient receives an outside diagnostic test or visits an outside physician, who pays for it? The _____ is responsible for the payment.
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A PPO is a health insurance plan where companies contract with physicians and hospitals, negotiating _____ fees.
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An EPO limits enrollee choice of providers and may or may not allow the use of _____ providers.
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Medicare Part A has no cost for people who meet eligibility for Social Security and covers inpatient hospital stays, hospice, and some _____ health services.
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Medicare Part B covers doctors' fees, with premiums taken out of Social Security checks, and includes certain doctor appointments, medical supplies, and _____ services.
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Medicare Part C is offered by private companies and can include HMO, PPO, and fee-for-service plans, and may cover _____ drugs.
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Medicare Part D specifically covers _____ drugs.
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On a resume, items should be listed in chronological order with the last degree earned at the _____.
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Is it appropriate to chew gum while waiting for an interview? The answer is _____.
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The method of CQI includes steps such as checklist, act, plan, do, and _____.
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Your license should match the testing _____ exactly.
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If you answer yes to any regulatory question, you must provide written _____ describing the events.
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