HPEX 300 Health Care Delivery in
America Exam 3 Solved 100% Correct
Capitation - ANSWER-Provider is paid a fixed amount per month per employee
Co- Payment - ANSWER-a payment made by a beneficiary in addition to that made by
an insurer
Co-Insurance - ANSWER-A type of insurance in which the insured pays a share of the
payment made against a claim
Cost Sharing - ANSWER-The share of costs covered by your insurance that you pay
out of your pocket
Deductible - ANSWER-A specific amount of money that the insured must pay before an
insurance company will pay a claim
Dependent Children - ANSWER-Offer plan for children to be covered under their
parents until age of 26
Fee-for-Service - ANSWER-is a payment model where services are unbundled and paid
for separately. In health care, it gives an incentive for physicians to provide more
treatments because payment is dependent on the quantity of care, rather than quality of
care
Group Insurance Policy - ANSWER-Provides group insurance plan to a select group
Group Model - ANSWER-Negotiates with groups of physicians exclusively to perform
services
ex. Kaiser Permanente
- first group model org
Health Maintenance Organization - ANSWER--Oldest type of managed care
-Members must see their primary care provider before seeing a specialist
Health Reimbursement Account - ANSWER-Employer-funded plans that reimburse
employees for incurred medical expenses that are not covered by the companies
standard insurance plan
Health Savings Account(HSA) - ANSWER-Tax advantaged medical savings account
available to tax payers who are enrolled in a high deductible health plan
America Exam 3 Solved 100% Correct
Capitation - ANSWER-Provider is paid a fixed amount per month per employee
Co- Payment - ANSWER-a payment made by a beneficiary in addition to that made by
an insurer
Co-Insurance - ANSWER-A type of insurance in which the insured pays a share of the
payment made against a claim
Cost Sharing - ANSWER-The share of costs covered by your insurance that you pay
out of your pocket
Deductible - ANSWER-A specific amount of money that the insured must pay before an
insurance company will pay a claim
Dependent Children - ANSWER-Offer plan for children to be covered under their
parents until age of 26
Fee-for-Service - ANSWER-is a payment model where services are unbundled and paid
for separately. In health care, it gives an incentive for physicians to provide more
treatments because payment is dependent on the quantity of care, rather than quality of
care
Group Insurance Policy - ANSWER-Provides group insurance plan to a select group
Group Model - ANSWER-Negotiates with groups of physicians exclusively to perform
services
ex. Kaiser Permanente
- first group model org
Health Maintenance Organization - ANSWER--Oldest type of managed care
-Members must see their primary care provider before seeing a specialist
Health Reimbursement Account - ANSWER-Employer-funded plans that reimburse
employees for incurred medical expenses that are not covered by the companies
standard insurance plan
Health Savings Account(HSA) - ANSWER-Tax advantaged medical savings account
available to tax payers who are enrolled in a high deductible health plan
