Dynamics: Chapter 19

1. The federally-funded health care program designed for older Americans is called

Medicare

Medicaid

Social Security

Welfare

2. Medicare, Medicaid, and TRICARE are all

Private insurance plans

Managed care plans

Government plans

Direct payment plans

Medicare and Medicaid resulted from the Social Security Act, TRICARE is for military and their families

Explanation

Medicare and Medicaid resulted from the Social Security Act, TRICARE is for military and their families

3. The monthly amount paid to a private insurance company for health insurancecoverage.

Deductible

Premium

Co-insurance

Co-pay

Companies pay a bulk of the insurance cost .

Explanation

Companies pay a bulk of the insurance cost .

4. The government program that provides health insurance for low-income anddisabled people is known as

Medicare

Medicaid

Social Security

Disability

5. One of the primary factors contributing to the high cost of health care is an _______________ population.

Immigrant

Aging

Obese

Unhealthy

6. A flat fee paid by the patient directly to the service provider each time the patientreceives a health care service

Deductible

Premium

Co-pay

Co-insurance

The insured pays a fixed fee for each date of service.

Explanation

The insured pays a fixed fee for each date of service.

7. The money a patient must pay before an insurance policy provides benefits.

Premium

Co-pay

Deductible

Co-insurance

Deductibles depend on the type of insurance one purchases. It can be $500.00-$5,000.00.

Explanation

Deductibles depend on the type of insurance one purchases. It can be $500.00-$5,000.00.

8. In return for federal, state, and local tax exemptions, ____________________________institutions must provide community benefits.

Proprietary

Government

For profit

Voluntary nonprofit

9. A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ allows patients to meet high deductibles with tax-free income and lets leftover funds be saved for future use.

Flexible spending account

Deductible

Health savings account

Co insurance

10. People use this type of payment when their insurance doesn't cover all health carecosts, when they don't have health insurance, or when they don't qualify for agovernment plan.

Prospective payment

Direct payment

Payroll deduction

Co-insurance

The uninsured person makes the payment for services directly to the provider.

Explanation

The uninsured person makes the payment for services directly to the provider.

11. The system used by Medicare and Medicaid to determine payment for healthservices based on diagnosis is the _______________________ classification system.

Health maintenance

Fee for service

Diagnostic related group

Prospective

12. A ______________ system provides coverage for health care through a select groupof providers, with predetermined rates for services.

Prospective payment

Health maintenance

Managed care

Government health

13. The process used by managed care plans to review care made by physicians and other health care providers is known as ________________________ review.

Quality care

In-network

Quality assurance

Utilization

14. Managed care plans place emphasis on ______________________ care.

Primary

Therapeutic

Prophylactic

Preventative

15. A/An _______________________provider is a physician under contract to provide services according to the terms of a managed care plan.

Gatekeeper

Primary care

In-network

Prospective care

16. The term _______________________ is used to describe physicians participating in managed care plans who provide primary care services and referrals to specialists.

Primary doctor

Gatekeeper

Managed care leader

In-network provider

Dynamics: Chapter 19

1. The federally-funded health care program designed for older Americans is called

2.

What first name or nickname would you like us to use?

2. Medicare, Medicaid, and TRICARE are all

3. The monthly amount paid to a private insurance company for health insurancecoverage.

4. The government program that provides health insurance for low-income anddisabled people is known as

5. One of the primary factors contributing to the high cost of health care is an _______________ population.

6. A flat fee paid by the patient directly to the service provider each time the patientreceives a health care service

7. The money a patient must pay before an insurance policy provides benefits.

8. In return for federal, state, and local tax exemptions, ____________________________institutions must provide community benefits.

9. A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ allows patients to meet high deductibles with tax-free income and lets leftover funds be saved for future use.

10. People use this type of payment when their insurance doesn't cover all health carecosts, when they don't have health insurance, or when they don't qualify for agovernment plan.

11. The system used by Medicare and Medicaid to determine payment for healthservices based on diagnosis is the _______________________ classification system.

12. A ______________ system provides coverage for health care through a select groupof providers, with predetermined rates for services.

13. The process used by managed care plans to review care made by physicians and other health care providers is known as ________________________ review.

14. Managed care plans place emphasis on ______________________ care.

15. A/An _______________________provider is a physician under contract to provide services according to the terms of a managed care plan.

16. The term _______________________ is used to describe physicians participating in managed care plans who provide primary care services and referrals to specialists.