Success in Practical/Vocational Nursing 9th Edition CH 16 Revised questions
with Correct Answers
Alliances - New partnerships among hospitals, clinics, laboratories, health care systems, and physicians.
They coordinate the delivery of care, contain costs, and attempt to provide seamless system.
Capitation - Set fee for health care, paid annually regardless of the number of health services provided.
Coinsurance - Percentage of total bill paid for by insurance company once deductible is paid.
Continuous Quality Improvement (CQI) - Search for new ways to improve patient care, prevent errors,
and identify and fix problems.
Copayment - Percentage of the bill that is paid by a person (subscriber) who is enrolled in a health
insurance plan.
Cost Containment - Holding costs within fixed limits.
Deductibles - Amount the subscriber must pay before health insurance begins to cover costs.
Diagnosis Related Group (DRG) - Prospective payment system. Specifies number of days for which
Medicare will pay, based on illness category.
Entitlement Program - Those eligible because of age, disability, or economic status are entitled by law to
benefits of certain programs, namely, Social Security, Medicare, and Medicaid.
fee-for-service - Patient pays the physician fee for each service provided.
Health Care Provider - A licensed health care person, such as a physician, dentist, or nurse practitioner,
whose health care services are covered by a health insurance plan.
Health maintenence organization (HMO) - A comprehensive care system of medical services based on a
set, prepaid fee.
with Correct Answers
Alliances - New partnerships among hospitals, clinics, laboratories, health care systems, and physicians.
They coordinate the delivery of care, contain costs, and attempt to provide seamless system.
Capitation - Set fee for health care, paid annually regardless of the number of health services provided.
Coinsurance - Percentage of total bill paid for by insurance company once deductible is paid.
Continuous Quality Improvement (CQI) - Search for new ways to improve patient care, prevent errors,
and identify and fix problems.
Copayment - Percentage of the bill that is paid by a person (subscriber) who is enrolled in a health
insurance plan.
Cost Containment - Holding costs within fixed limits.
Deductibles - Amount the subscriber must pay before health insurance begins to cover costs.
Diagnosis Related Group (DRG) - Prospective payment system. Specifies number of days for which
Medicare will pay, based on illness category.
Entitlement Program - Those eligible because of age, disability, or economic status are entitled by law to
benefits of certain programs, namely, Social Security, Medicare, and Medicaid.
fee-for-service - Patient pays the physician fee for each service provided.
Health Care Provider - A licensed health care person, such as a physician, dentist, or nurse practitioner,
whose health care services are covered by a health insurance plan.
Health maintenence organization (HMO) - A comprehensive care system of medical services based on a
set, prepaid fee.
