NU 180 Exam 3 Review Questions and
Answers with Verified Solutions | Latest
Updated 2026
Premium Monthly fee paid for health insurance
coverage.
Deductible Annual out-of-pocket amount paid before
insurance covers expenses.
Copayment Set fee paid at the time of service (office
visit,
medication).
Coinsurance Percentage of bill paid by the insured after
deductible is met.
Capitation A set monthly fee charged per patient for
defined
services (cost-containment model).
Fee-for-service Traditional model where providers are paid
for
each service.
Medicare Federal program for those 65+ or with
qualifying
disabilities.
, Medicare Part A Covers hospital and inpatient care.
Medicare Part B Covers physician and outpatient care.
Medicaid State & federally funded program based on
income
need, helping low-income families,
pregnant
women, and disabled individuals.
Diagnosis-Related Groups (DRGs) Predetermined payment amounts for
diagnoses,
encouraging shorter hospital stays.
Prospective Payment System Hospital knows in advance what it will be
paid,
creating an incentive to discharge early.
Continuous Quality Improvement Ongoing monitoring to improve safety,
(CQI) processes,
and patient outcomes.
Cost-Containment Nursing Actions Actions include documenting accurately for
reimbursement, managing time efficiently,
using
supplies wisely, and preventing
complications.
Primary Care First entry into the healthcare system
(referring MD,
NP, ambulatory clinic).
Answers with Verified Solutions | Latest
Updated 2026
Premium Monthly fee paid for health insurance
coverage.
Deductible Annual out-of-pocket amount paid before
insurance covers expenses.
Copayment Set fee paid at the time of service (office
visit,
medication).
Coinsurance Percentage of bill paid by the insured after
deductible is met.
Capitation A set monthly fee charged per patient for
defined
services (cost-containment model).
Fee-for-service Traditional model where providers are paid
for
each service.
Medicare Federal program for those 65+ or with
qualifying
disabilities.
, Medicare Part A Covers hospital and inpatient care.
Medicare Part B Covers physician and outpatient care.
Medicaid State & federally funded program based on
income
need, helping low-income families,
pregnant
women, and disabled individuals.
Diagnosis-Related Groups (DRGs) Predetermined payment amounts for
diagnoses,
encouraging shorter hospital stays.
Prospective Payment System Hospital knows in advance what it will be
paid,
creating an incentive to discharge early.
Continuous Quality Improvement Ongoing monitoring to improve safety,
(CQI) processes,
and patient outcomes.
Cost-Containment Nursing Actions Actions include documenting accurately for
reimbursement, managing time efficiently,
using
supplies wisely, and preventing
complications.
Primary Care First entry into the healthcare system
(referring MD,
NP, ambulatory clinic).
