Healthcare Financing, Medicare, Medicaid,
Affordable Care Act, Cost Accounting, Managed
Care & Reimbursement Systems.
Practice questions (ch. 5,6,7)
The most common third-party payers in the United States healthcare system are
the government and insurance companies
Third-party payers are
agents of patients that contract with providers to pay patients medical bills
Which organization offered prepaid medical care to school teachers?
Baylor University Hospital
Under a direct service plan, the employer prepays ______ to take care of its employees.
specific hospitals and physicians
Under a commercial indemnity plan, the employer pays ______, which reimburses ______.
an insurance company; a hospital or physician of the employees' choosing
Which three aspects of healthcare do managed care organizations address?
Quality, access, cost
______ plans allow members to seek care from a provider outside the network for a higher
premium, coinsurance rate, or deductible.
POS
The Affordable Care Act of 2010 set out to
-Provide insurance to the 32 million Americans still uninsured
-Require individuals to have health insurance
-Reduce the rate of increase for Medicare and Medicaid spending
Most providers agree that ______ is the best way to be reimbursed.
charges