HIM 410 final exam questions and
answers
The Temporary Assistance for Needy Families (TANF) - ANSWERS -Which program replaced Aid
to Families with Dependent Children?
primary objective of health care system - ANSWERS -1. enable all citizens to receive health
services
2. To deliver services that are cost effective and meet established standards of quality
national health care system - ANSWERS -health insurance programs run by the government and
financed through general taxes
socialized health care system - ANSWERS -government mandated contributions by employers
and employees. Health care delivered by private providers. Private not for profit insurance
companies called sickness funds collect and pay physicians and hospitals. Insurance and
payment closely integrated, GOVERNMENT has overall control
public health - ANSWERS -a wide variety of activities undertaken by state and local governments
to ensure conditions that promote optimum health for society as a whole
private practice - ANSWERS -the work of a professional practitioner, such as a doctor or lawyer,
who is self employed
organized medicine - ANSWERS -concerted activities of physicians, mainly to protect their own
interest through such organizations such as the american medical association. when physicians
join an organization in oder to advocate for themselves and their patients.
,defensive medicine - ANSWERS -excessive medical test and procedures performed as protection
against malpractice law suits. recommending tests that are not necessarily the best option for
the patient but an option that serves to protect the physician from lawsuit
physicians - ANSWERS -play central role in evaluating patient, states require licensure, graduate
from an accredited medical school
MD - ANSWERS -doctor of medicine
DO - ANSWERS -doctor of osteopathic medicine
allied health professionals - ANSWERS -includes many health related areas. constitutes 60% of
US health care workforce. Two broad categories: technicians/assistants, therapists/technologists
nurses - ANSWERS -largest group of healthcare professionals, profession developed after WWI,
the major caregivers of sick and injured patients (addressing physical, mental and emotional
needs) need to be licensed to practice
RN - ANSWERS -registered nurse
LPN - ANSWERS -licensed practical nurse
non-physician practitioners - ANSWERS -clinical professionals who practice in many areas similar
to a physician but do not have a physician or DO degree. (PA, nurse practitioner)
national practitioner bank - ANSWERS -an electronic information repository created by
congress. contains information on medical malpractice payments and certain adverse actions
related to health care practitioners, entities, providers and suppliers
, voluntary health insurance - ANSWERS -private insurance. decision to join and payment of a
premium is voluntary
third party - ANSWERS -in a multi-payer system, the PAYERS for covered services. neither the
providers nor the recipients of medical services.
prospective payment - ANSWERS -criteria for how much will be paid for particular services is
predetermined
retrospective payment - ANSWERS -amount of reimbursement is determined on the basis of
costs actually incurred. methods of case-based payment
episode of care - ANSWERS -the managed care provided by a healthcare facility or provider for a
specific medical problem or condition or specific illness during a set period of time
fee for service - ANSWERS -payment model where services are unbundled and paid for
separately
group health insurance - ANSWERS -an insurance plan/policy purchased by an organization or
association as a benefit to its employees or members. typical groups are employers, union, or
trade works, and professional associations
cost sharing provisions - ANSWERS -sharing of cost of health insurance premiums by those
enrolled and or payment of of certain medical costs such as copayments and deductibles. The
share of costs covered by your insurances that you pay out of pocket*
coordination of benefits - ANSWERS -the process of determining which of two or more
insurance policies will have the primary responsibility of processing/paying a claim and the
extent to which the other policies will contribute.
answers
The Temporary Assistance for Needy Families (TANF) - ANSWERS -Which program replaced Aid
to Families with Dependent Children?
primary objective of health care system - ANSWERS -1. enable all citizens to receive health
services
2. To deliver services that are cost effective and meet established standards of quality
national health care system - ANSWERS -health insurance programs run by the government and
financed through general taxes
socialized health care system - ANSWERS -government mandated contributions by employers
and employees. Health care delivered by private providers. Private not for profit insurance
companies called sickness funds collect and pay physicians and hospitals. Insurance and
payment closely integrated, GOVERNMENT has overall control
public health - ANSWERS -a wide variety of activities undertaken by state and local governments
to ensure conditions that promote optimum health for society as a whole
private practice - ANSWERS -the work of a professional practitioner, such as a doctor or lawyer,
who is self employed
organized medicine - ANSWERS -concerted activities of physicians, mainly to protect their own
interest through such organizations such as the american medical association. when physicians
join an organization in oder to advocate for themselves and their patients.
,defensive medicine - ANSWERS -excessive medical test and procedures performed as protection
against malpractice law suits. recommending tests that are not necessarily the best option for
the patient but an option that serves to protect the physician from lawsuit
physicians - ANSWERS -play central role in evaluating patient, states require licensure, graduate
from an accredited medical school
MD - ANSWERS -doctor of medicine
DO - ANSWERS -doctor of osteopathic medicine
allied health professionals - ANSWERS -includes many health related areas. constitutes 60% of
US health care workforce. Two broad categories: technicians/assistants, therapists/technologists
nurses - ANSWERS -largest group of healthcare professionals, profession developed after WWI,
the major caregivers of sick and injured patients (addressing physical, mental and emotional
needs) need to be licensed to practice
RN - ANSWERS -registered nurse
LPN - ANSWERS -licensed practical nurse
non-physician practitioners - ANSWERS -clinical professionals who practice in many areas similar
to a physician but do not have a physician or DO degree. (PA, nurse practitioner)
national practitioner bank - ANSWERS -an electronic information repository created by
congress. contains information on medical malpractice payments and certain adverse actions
related to health care practitioners, entities, providers and suppliers
, voluntary health insurance - ANSWERS -private insurance. decision to join and payment of a
premium is voluntary
third party - ANSWERS -in a multi-payer system, the PAYERS for covered services. neither the
providers nor the recipients of medical services.
prospective payment - ANSWERS -criteria for how much will be paid for particular services is
predetermined
retrospective payment - ANSWERS -amount of reimbursement is determined on the basis of
costs actually incurred. methods of case-based payment
episode of care - ANSWERS -the managed care provided by a healthcare facility or provider for a
specific medical problem or condition or specific illness during a set period of time
fee for service - ANSWERS -payment model where services are unbundled and paid for
separately
group health insurance - ANSWERS -an insurance plan/policy purchased by an organization or
association as a benefit to its employees or members. typical groups are employers, union, or
trade works, and professional associations
cost sharing provisions - ANSWERS -sharing of cost of health insurance premiums by those
enrolled and or payment of of certain medical costs such as copayments and deductibles. The
share of costs covered by your insurances that you pay out of pocket*
coordination of benefits - ANSWERS -the process of determining which of two or more
insurance policies will have the primary responsibility of processing/paying a claim and the
extent to which the other policies will contribute.
