Health Insurance Chap 7 & Ess. Chap 5 & Pharm. Chap 23

99 Questions | Attempts: 86
Please wait...
Question 1 / 99
0 %
0/100
Score 0/100
1. With many MCOs the enrollee typically pays a small fee upfront when visiting his/her PCP called a ________________
Submit
Please wait...
About This Quiz
Health Insurance Quizzes & Trivia

Review week 3 mod 6

2.
We’ll put your name on your report, certificate, and leaderboard.
2. A "hybird" type of managed care (also called an open ended HMO) that allows patients to use either their HMO provider or go outside the plan and use a provider of their choices is a/ an _______________
Submit
3. A request by a healthcare provider for a patient under his/her care to be treated by another provider usually a specialist is a _______ (hint total care is often transferred)
Submit
4. When a patient is sent to another provider (often a specialist) with the intent of rendering an expert opinion only this is a ___________consultation  (hint total care is not transferred)
Submit
5. MCOs tend to focus on ____________ care, or keeping the patient well thus avoiding expensive treatment later on
Submit
6. __________________ pertains to medical necessity and appropriateness only and does not in all instances guarantee payment
Submit
7. A process used by health insurance companies to control health care costs similar to prequthorization is
Submit
8. The ________________ model HMO is similar to an IPA except the organization contracts directly with individual providers
Submit
9. Symptoms of corneal abrasion or ulcer include pain, redness, tearing, and sometimes visual impairment
Submit
10. Serious otitis media may be either acute or chronic
Submit
11. A referral is exactly the same as a consultation
Submit
12. A specific provider who oversees the entire care and treatment of a patient in an HMO is called a
Submit
13. The private not for profit organization that is dedicated to improving healthcare quality and is frequently referred to as the managed care "watch dog" is ___________
Submit
14. HMOs normally do not have _____________ or plan limits
Submit
15. Managed care has had little impact on healthcare in general in the united states
Submit
16. The purpose of a consultation is to obtain an expert opinion only and care of the patient is not relinquished to the consulting provider
Submit
17. One primary function of a managed care organization (MCO) is to establish a list of covered benefits tied to managed care rules
Submit
18. A predominant standard setting nonprofit organization that evaluates and accredits healthcare organizations in the united states is the ______________
Submit
19. A _____________________ is used in managed care plans to reduce unnecessary inpatient/outpatient services
Submit
20. The internal lens of the eye is elastic and therefore can focus images both near and far
Submit
21. Keratitis is frequently caused by an infection of herpes simplex virus
Submit
22. Chronic open end glaucoma results from a malfunction of the drainage system which causes intraocular pressure to be raised
Submit
23. One advantage of an MCO is that it never has to be accredited
Submit
24. The only treatment that cures otosclerosis is a surgical procedure called stapedectomy
Submit
25. A cholesteatoma and mastoiditis can both be the result of a neglected otitis media
Submit
26. Macular degeneration is
Submit
27. This federal act, passed in 1996 is intended to improve the efficiency of healthcare delivery, reduce administrative cost and protect patient privacy
Submit
28. Sensorineural hearing loss that is caused by damage to the cochlea is irreversible, therefore prevention is essential
Submit
29. Glaucoma only occurs after age 60
Submit
30. Members of an HMO normally pay only a small fee (called a copayment) each time they visit their healthcare provider
Submit
31. A specific provider who oversees the total healthcare treatment of an individual enrolled in certain managed care plans is a
Submit
32. A relatively small out of pocket dollar amount that a member of a managed care plan typicallys pays up front is a
Submit
33. An advantage of managed care organizations (MCOs) is that their aim is to keep their enrollees healthy which is commonly referred to as
Submit
34. A request by a healthcare provider for his/her patient to be evaluated or treated by a specialist is a
Submit
35. Treatment of refractive errors of the eye might include
Submit
36. Inflammatory infections of the hair follicles of the eyelid are called
Submit
37. Infection or inflammation in the semicircular canals is called
Submit
38. Which of the following might be prescribed to aid in smoking cessation
Submit
39. A healthcare provider trained in a specific medical specialty is a
Submit
40. With a point of service type HMO patients are allowed to go outside the plan and use any provider they choose
Submit
41. The middle ear is normally air filled
Submit
42. Toxic levels of lithium (lithane) may be associated with which of the following symptoms
Submit
43. The peripheral nervous system referes to the nervous structures outside of the
Submit
44. The formal term for a written complaint submitted by an individual covered by a special plan or policy is called a
Submit
45. A procedure required by most healthcare plans before a provider carries out  specific procedures or treatment is a/an
Submit
46. One of the more popular types of MCO in this country is the preferred provider organization (PPO)
Submit
47. When reporting a craniectomy/craniotomy procedure it is common to also code _____ procedures
Submit
48. Weaning patients from selective serotonin re-uptake inhibitors (SSRIs) will reduce the likelihood of which of the following post treatment symptoms
Submit
49. An inflammation of the thin transparent membrane covering the visible portion of the sclera and lining the inside of the eyelids results in
Submit
50. Conjunctivitis can be caused by
Submit
51. A cloudy or opaque area in the normally clear lens of the eye is called a
Submit
52. Blepharoptosis can be ectropion or entropion
Submit
53. Patients on monoamine oxidase inhibitors (MAOIs) must observe which of the following dietary restrictions
Submit
54. A healthcare delivery system that controls utilization and cost of services while providing enrollees access to quality cost effective healthcare is
Submit
55. Under the federal HMO act an entity must have five characteristics to call itself an HMO
Submit
56. Precertification is a process people must go through to become eligible to join an HMO
Submit
57. The ears only function is hearing
Submit
58. The future of managed care is clear cut it is predicted that it will totally eliminate traditional healthcare in 10 years
Submit
59. A system designed to determine the medical necessity and appropriateness of a requested medical service or procedure is a/an
Submit
60. Early symptoms of retinal detachment consist of
Submit
61. Shunts are devices used to
Submit
62. Symptoms of neoplasms of the ear commonly include
Submit
63. A procedure required by most healthcare plans before a provider carries out specific procedures or treatment is a/an
Submit
64. The cause of sensorineural deafness also referred to as occupational hearing loss includes
Submit
65. A multispeciality practice in which healthcare services are provided within the building complex owned by the health maintenance organization (HMO) is referred to as a/an
Submit
66. An independent not for profit organization that sets standards for healthcare in the united states and accredits most major hospitals is the
Submit
67. Which of the following medications would be prescribed for bipolar affective disorder
Submit
68. Extapyramidal side effects include which of the following
Submit
69. Chlorpromazine (thorazine) may cause which of the following side effects
Submit
70. For treating depression in the elderly which of the following medications would be useful because it does not cause over stimulation on days when depression does not occur
Submit
71. A chronic disease of the inner ear marked by a recurring syndrome of vertigo, tinnitus, progressive hearing loss and a sensation of pressure in the ear is called
Submit
72. Fluphenazine (prolixin) is different from other tranquilizers in which of the following ways?
Submit
73. The nurse should be sure to include which of the following facts in patient education about antidepressant agents
Submit
74. The insertion of a tympanostomy tube as a treatment for otitis media is called
Submit
75. The major risk with having a ruptured eardrum is infection in the inner ear
Submit
76. In the surgery of the skull base the _____ procedure is what is done to the lesion
Submit
77. Vision impairment as a result of old age and the loss of elasticity in the lens is called
Submit
78. Ramelteon (rozerem) is indicated for which of the following sleep disturbances
Submit
79. Neuroplasty is the
Submit
80. Individuals who are members of a managed care plan are commonly referred to as
Submit
81. Ankylosing of the stapes is called
Submit
82. Hyperopia myopia and presbyopia are refractive errors that result when the
Submit
83. A group of healthcare providers working under one umbrella to provide medical services at a discount to the individuals who participate in the plan is referred to as a/an
Submit
84. In the surgery of skull base the __________ procedure is the method used to obtain exposure of the lesion
Submit
85. The initials that indicate a shunting procedure are
Submit
86. Placement of sharp objects into the ear canal an explosion a severe middle ear infection or a blow to the ear could result in
Submit
87. What procedure is often performed with a laminectomy
Submit
88. Which of the following statement(s) is (are) true about nystagmus
Submit
89. Which of the following statements is true about chronic open angle glaucoma
Submit
90. This is the most commonly known neuroplastic procedure
Submit
91. A private nonprofit organization that accredits healthcare plans based on evaluation of the quality of care given to plan members is the
Submit
92. The sensor receptive cells in the retina that function best in dim light and enable night vision are the
Submit
93. A type of HMO whereby services are provided by outpatient networks composed of individual healthcare providers who supply all necessary patient care is a/an
Submit
94. A major cause of blindness in the united states is
Submit
95. Causes of conductive hearing loss might include
Submit
96. A defect in the _____ results in difficulty in visual detection of color and fine detail
Submit
97. During skull based surgery if one surgeon performs the approach and a second physician performs the definitive procedure and a third physician performs the closure what modifier is appended to the definitive procedure code
Submit
98. Venlafaxine hydrocholoride (effexor) is different from other medications in its class in which of the following ways? select all that apply
Submit
99. List the three main objectives of HIPAA
Submit
View My Results
Cancel
  • All
    All (99)
  • Unanswered
    Unanswered ()
  • Answered
    Answered ()
With many MCOs the enrollee typically pays a small fee upfront when...
A "hybird" type of managed care (also called an open ended HMO) that...
A request by a healthcare provider for a patient under his/her care to...
When a patient is sent to another provider (often a specialist) with...
MCOs tend to focus on ____________ care, or keeping the patient well...
__________________ pertains to medical necessity and appropriateness...
A process used by health insurance companies to control health care...
The ________________ model HMO is similar to an IPA except the...
Symptoms of corneal abrasion or ulcer include pain, redness, tearing,...
Serious otitis media may be either acute or chronic
A referral is exactly the same as a consultation
A specific provider who oversees the entire care and treatment of a...
The private not for profit organization that is dedicated to improving...
HMOs normally do not have _____________ or plan limits
Managed care has had little impact on healthcare in general in the...
The purpose of a consultation is to obtain an expert opinion only and...
One primary function of a managed care organization (MCO) is to...
A predominant standard setting nonprofit organization that evaluates...
A _____________________ is used in managed care plans to reduce...
The internal lens of the eye is elastic and therefore can focus images...
Keratitis is frequently caused by an infection of herpes simplex virus
Chronic open end glaucoma results from a malfunction of the drainage...
One advantage of an MCO is that it never has to be accredited
The only treatment that cures otosclerosis is a surgical procedure...
A cholesteatoma and mastoiditis can both be the result of a neglected...
Macular degeneration is
This federal act, passed in 1996 is intended to improve the efficiency...
Sensorineural hearing loss that is caused by damage to the cochlea is...
Glaucoma only occurs after age 60
Members of an HMO normally pay only a small fee (called a copayment)...
A specific provider who oversees the total healthcare treatment of an...
A relatively small out of pocket dollar amount that a member of a...
An advantage of managed care organizations (MCOs) is that their aim is...
A request by a healthcare provider for his/her patient to be evaluated...
Treatment of refractive errors of the eye might include
Inflammatory infections of the hair follicles of the eyelid are called
Infection or inflammation in the semicircular canals is called
Which of the following might be prescribed to aid in smoking cessation
A healthcare provider trained in a specific medical specialty is a
With a point of service type HMO patients are allowed to go outside...
The middle ear is normally air filled
Toxic levels of lithium (lithane) may be associated with which of the...
The peripheral nervous system referes to the nervous structures...
The formal term for a written complaint submitted by an individual...
A procedure required by most healthcare plans before a provider...
One of the more popular types of MCO in this country is the preferred...
When reporting a craniectomy/craniotomy procedure it is common to also...
Weaning patients from selective serotonin re-uptake inhibitors (SSRIs)...
An inflammation of the thin transparent membrane covering the visible...
Conjunctivitis can be caused by
A cloudy or opaque area in the normally clear lens of the eye is...
Blepharoptosis can be ectropion or entropion
Patients on monoamine oxidase inhibitors (MAOIs) must observe which of...
A healthcare delivery system that controls utilization and cost of...
Under the federal HMO act an entity must have five characteristics to...
Precertification is a process people must go through to become...
The ears only function is hearing
The future of managed care is clear cut it is predicted that it will...
A system designed to determine the medical necessity and...
Early symptoms of retinal detachment consist of
Shunts are devices used to
Symptoms of neoplasms of the ear commonly include
A procedure required by most healthcare plans before a provider...
The cause of sensorineural deafness also referred to as occupational...
A multispeciality practice in which healthcare services are provided...
An independent not for profit organization that sets standards for...
Which of the following medications would be prescribed for bipolar...
Extapyramidal side effects include which of the following
Chlorpromazine (thorazine) may cause which of the following side...
For treating depression in the elderly which of the following...
A chronic disease of the inner ear marked by a recurring syndrome of...
Fluphenazine (prolixin) is different from other tranquilizers in which...
The nurse should be sure to include which of the following facts in...
The insertion of a tympanostomy tube as a treatment for otitis media...
The major risk with having a ruptured eardrum is infection in the...
In the surgery of the skull base the _____ procedure is what is done...
Vision impairment as a result of old age and the loss of elasticity in...
Ramelteon (rozerem) is indicated for which of the following sleep...
Neuroplasty is the
Individuals who are members of a managed care plan are commonly...
Ankylosing of the stapes is called
Hyperopia myopia and presbyopia are refractive errors that result when...
A group of healthcare providers working under one umbrella to provide...
In the surgery of skull base the __________ procedure is the method...
The initials that indicate a shunting procedure are
Placement of sharp objects into the ear canal an explosion a severe...
What procedure is often performed with a laminectomy
Which of the following statement(s) is (are) true about nystagmus
Which of the following statements is true about chronic open angle...
This is the most commonly known neuroplastic procedure
A private nonprofit organization that accredits healthcare plans based...
The sensor receptive cells in the retina that function best in dim...
A type of HMO whereby services are provided by outpatient networks...
A major cause of blindness in the united states is
Causes of conductive hearing loss might include
A defect in the _____ results in difficulty in visual detection of...
During skull based surgery if one surgeon performs the approach and a...
Venlafaxine hydrocholoride (effexor) is different from other...
List the three main objectives of HIPAA
Alert!

Back to Top Back to top
Advertisement