Question 1

Match the following
-The type of managed care plan that hires the physicians and pays their salaries

Accepted Answer

A)  individual practice association (IP
A)  health maintenance organization (HMO) 
B)  staff model health maintenance organization (HMO) 
C)  major medical insurance 
D)  outpatient insurance 
E)  open access health maintenance
F) exclusive provider organization (EPO)
G) point-of-service (POS) plan
H) network model health maintenance organization (HMO)
I) long-term care insurance
J) preferred provider organization (PPO) 
A)  individual practice association (IP
A)  health maintenance organization (HMO) 
B)  staff model health maintenance organization (HMO) 
C)  major medical insurance 
D)  outpatient insurance 
E)  open access health maintenance
F) exclusive provider organization (EPO)
G) point-of-service (POS) plan
H) network model health maintenance organization (HMO)
I) long-term care insurance
J) preferred provider organization (PPO)

Question 2

The amount that insured individuals have to pay out of pocket before insurance begins paying is called the ________.

Accepted Answer

The answer of The amount that insured individuals have to...

Question 3

List four goals of managed care.

Accepted Answer

Goals of managed care are to ensure that

Question 4

Explain the difference between a premium and a deductible.

Accepted Answer

A premium is the amount paid (

Question 5

When a provider agrees to receive payment directly from the patient's insurance carrier, it is accepting ________.

Accepted Answer

assignment

Question 6

Managed care systems ensure the delivery of high-quality care while managing costs through:

Accepted Answer

A)  provider networks and discounted fees for services. 
B)  provider networks and regular premium increases. 
C)  prohibiting the use of out-of-network providers. 
D)  discounted fees for services and mandatory high deductibles across all health plans. 
A)  provider networks and discounted fees for services. 
B)  provider networks and regular premium increases. 
C)  prohibiting the use of out-of-network providers. 
D)  discounted fees for services and mandatory high deductibles across all health plans.

Match the following -The type of managed care plan that hires the physicians and pays their salaries

The amount that insured individuals have to pay out of pocket before insurance begins paying is called the ________.

List four goals of managed care.

Explain the difference between a premium and a deductible.

When a provider agrees to receive payment directly from the patient's insurance carrier, it is accepting ________.

Managed care systems ensure the delivery of high-quality care while managing costs through:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 2: Understanding Managed Care: Insurance Plans

Match the following -The type of managed care plan that hires the physicians and pays their salaries

The amount that insured individuals have to pay out of pocket before insurance begins paying is called the ________.

List four goals of managed care.

Explain the difference between a premium and a deductible.

When a provider agrees to receive payment directly from the patient's insurance carrier, it is accepting ________.

Managed care systems ensure the delivery of high-quality care while managing costs through:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters