NWCA STUDY GUIDE QUESTIONS AND ANSWERS.docx

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NWCA STUDY GUIDE QUESTIONS AND ANSWERS.docx

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2025/2026

Institution NWCA

Course NWCA

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NWCA STUDY GUIDE QUESTIONS AND ANSWERS.docx

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NWCA STUDY GUIDE QUESTIONS
AND ANSWERS

Managed0Care0Organization0(MCO)0-
0ans✔Combines0functions0of0health0insurance,0delivery0of0care0and0administration

Exclusive0Provider0Organization0(EPO)0-
0ans✔Services0covered0only0if0use0doctors,0specialists0or0hospitals0in0plans0network0(
except0in0hospitals)

Health0Maintenance0Organization0(HMO)0-
0ans✔Limits0coverage0to0care0from0doctors0who0work0for0or0contract0with0the0HMO,0g
enerally0won't0cover0out0of0network0care0except0in0emergency.0May0require0to0live0or0
work0in0its0service0area.

Point0of0Service0(POS)0-
0ans✔Pay0less0if0you0use0doctors,0and0other0health0care0providers0that0belong0to0the0
plans0network,0required0to0get0a0referral0from0primary0care0doctor0in0order0to0see0spe
cialist

Quality0Improvement0Organization0(QIO)0-
0ans✔Physician0can0hose0whether0or0not0accept0Medicare0patients,0who0are0seeking0
non0medical0services,0signs0an0agreement0and0May0sign0a0participating0provider0agre
ement(PAR)

Preferred0Provider0Organization0(PPO)0-
0ans✔Pay0less0if0use0providers0in0plans0network.0Can0use0providers0outside0of0networ
k0without0a0referral0for0N0additional0cost.

DHHS0stands0for0-0ans✔Department0of0health0and0human0services

Medicare0Administrative0Contractor0(MAC)0is0-
0ans✔A0private0health0care0insurer0awarded0geographic0jurisdiction0to0process0medic
are0A0y0B

Medicare0A0covers0-
0ans✔Hospital0care,0skilled0nursing0facility0care,0nursing0home,0(0as0long0as0custodial0
care0isn't0the0only0type0of0care0needed),0hospice,0o0e0health0services

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Uploaded on: December 18, 2025
Number of pages: 3
Written in: 2025/2026
Type: Exam (elaborations)
Contains: Questions & answers

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