Table of Contents
- 1 Which terms best describes those who receive managed health care plan services?
- 2 Which of the following is the term which describes a group of health care providers and facilities contracted by an insurance provider to provide care to insured customers?
- 3 What is managed health care plan?
- 4 What managed care means?
- 5 What are the three main types of managed care organizations?
- 6 What is the purpose of managed care plans?
- 7 How much does capitation pay for managed care?
Which terms best describes those who receive managed health care plan services?
Health Insurance Claims Chapter 3
| Question | Answer |
|---|---|
| Which term best describes those who receive managed health care plan services? | enrollees |
| What was created in 1929? | the first managed care program |
| Which was the first nationally recognized health maintenance organization? | Kaiser Permanente |
Which of the following is an example of a managed care plan?
D) Any insurance company that markets group health insurance is an HMO. An HMO offers comprehensive services on a prepaid basis to its subscribing members. An insurance company may sponsor an HMO or assist an HMO by providing contractual services. Many HMOs are independent.
Which of the following is the term which describes a group of health care providers and facilities contracted by an insurance provider to provide care to insured customers?
Physician-Hospital Organization
Physician-Hospital Organization (PHO) A contracted arrangement among physicians and hospitals wherein a single entity, the Physician Hospital Organization, contracts to provide services to insurers’ subscribers. 6.
What type of managed care model has a contracted network of healthcare providers that provide care to subscribers for a discounted fee?
Preferred Provider Organization – Contracted network of health providers that provide care to subscribers for a discounted fee.
What is managed health care plan?
Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. Plans that restrict your choices usually cost you less.
What is managed care quizlet?
managed care. an organized effort by health plans and providers to use financial incentives and organizational. arrangements to alter provider and patient behavior so that health care services are delivered and utilized in a more. efficient and lower cost manner.
What managed care means?
Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. Health Maintenance Organizations (HMO) usually only pay for care within the network.
What is managed healthcare?
Managed Care is a health care delivery system organized to manage cost, utilization, and quality. By contracting with various types of MCOs to deliver Medicaid program health care services to their beneficiaries, states can reduce Medicaid program costs and better manage utilization of health services.
What are the three main types of managed care organizations?
There are three types of managed care plans:
- Health Maintenance Organizations (HMO) usually only pay for care within the network.
- Preferred Provider Organizations (PPO) usually pay more if you get care within the network.
- Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.
What are the four types of managed care plans?
There are four main types of managed health care plans: health maintenance organization (HMO), preferred provider organization (PPO), point of service (POS), and exclusive provider organization (EPO).
What is the purpose of managed care plans?
Its main purpose is to better serve plan members by focusing on prevention and care management, which helps produce better patient outcomes and healthier lives. Managed care also helps control costs so you can save money.
What is the intent of managed health care?
The intent of managed health care was to Enrollees Which term best describes those who receive managed healthcare plan services Retained by the Medical Center as profit The Medical Center received a $100,000 capitation payment in January to cover the healthcare costs of 150 managed care enrollees.
How much does capitation pay for managed care?
The medical center received a $100,000 capitation payment in January to cover healthcare cost of 150 managed care enrollees. By the following January,$80,000 had been expended to cover services provided.
What are the benefits of an HMO plan?
Provides benefits to subscribers who are required to receive services from network providers HMO Provides comprehensive healthcare services to voluntarily enrolled members on a prepaid basis POS