HCA-110 Final Exam Rated A+ 2025
(AKA before, during, and after) - ANSWER-What are the 3 phases to utilization review?
1983 - ANSWER-DRGs started in ______
2010 - ANSWER-The ACA started in ________
3 - ANSWER-There are ____ phases to Utilization Review
4 - ANSWER-Big hospitals cost more, this makes the bigger/ more expensive hospitals
part of tier _________
4 - ANSWER-How many tiers does insurance have?
4 - ANSWER-Tier __________ is the most expensive
9% - ANSWER-___% of people in the US are uninsured
a second opinion - ANSWER-A second party physician that gives a second opinion on
surgeries is _____________
about 10 years - ANSWER-How long did HMOs last?
ACA - ANSWER-Another form of capitation is the ________
Access to EMR, this makes it easier to report their patient data to the government (for
the ACA to observe the care that the patients are receiving) - ANSWER-Why do doctors
want to join healthcare systems rather than being independently working in their own
practice?
Because the government says they will only pay the hospitals "x" amount of days and if
the patient is there any longer the hospital will lose money because the government will
not cover it - ANSWER-Why did DRG's speed up the hospitals?
Capitation - ANSWER-______ is the opposite of fee for service
closed - ANSWER-HMO's is considered a _______ model
Copays and deductibles - ANSWER-In health insurance what do individuals pay?
Diagnosis Related Groups = Medicare pays predetermined amount for a specific
diagnosis based on average of how much treatment for this condition should cost
(AKA before, during, and after) - ANSWER-What are the 3 phases to utilization review?
1983 - ANSWER-DRGs started in ______
2010 - ANSWER-The ACA started in ________
3 - ANSWER-There are ____ phases to Utilization Review
4 - ANSWER-Big hospitals cost more, this makes the bigger/ more expensive hospitals
part of tier _________
4 - ANSWER-How many tiers does insurance have?
4 - ANSWER-Tier __________ is the most expensive
9% - ANSWER-___% of people in the US are uninsured
a second opinion - ANSWER-A second party physician that gives a second opinion on
surgeries is _____________
about 10 years - ANSWER-How long did HMOs last?
ACA - ANSWER-Another form of capitation is the ________
Access to EMR, this makes it easier to report their patient data to the government (for
the ACA to observe the care that the patients are receiving) - ANSWER-Why do doctors
want to join healthcare systems rather than being independently working in their own
practice?
Because the government says they will only pay the hospitals "x" amount of days and if
the patient is there any longer the hospital will lose money because the government will
not cover it - ANSWER-Why did DRG's speed up the hospitals?
Capitation - ANSWER-______ is the opposite of fee for service
closed - ANSWER-HMO's is considered a _______ model
Copays and deductibles - ANSWER-In health insurance what do individuals pay?
Diagnosis Related Groups = Medicare pays predetermined amount for a specific
diagnosis based on average of how much treatment for this condition should cost
