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law/ethics ch 4
medical law & ethics ch 4 test
| Question | Answer |
|---|---|
| A fixed payment plan of health insurance offers coverage for | complete medical care |
| Third party payers are | insurance companies |
| The purpose of the gatekeeper is to | a) approve all non-emergency services, b) approve hospitalizations, & c) approve tests before they are given |
| In a managed care organization, financial risk is shared by the | a) organization, b) hospital, & c) physician |
| A gag clause, considered illegal in contracts between physicians and managed care organizations | prohibits the physician from discussing financial incentives given by the organization |
| Managed care organizations may attempt to limit a patient's | a) choice of hospital, b) referals to specialists, & c) length of stay in a hospital |
| A health maintenance organization (HMO) provides | healthcare services available for a predetermined fee per member by a limited group providers |
| Capitation is | a fixed monthly fee paid to the healthcare provider for providing patient services |
| Medicare is a federal program of | b) healthcare coverage in which rationing of care might occur in the future & c) healthcare coverage for the elderly and disabled |
| Medicaid is a | federal program of care for the poor implemented by the states |
| A medicare-instituted method of hospital payment is | DRG |
| Diagnosis-related groups refer to | the classification of patients of illness by diagnosis |
| Those persons most likely to receive the best care under a managed care system are | those who understand the system |
| Medicare and Medicaid prohibit physicians from | referring to services they own |
| Different methods of medical practice, such as partnerships and corporations, are the result of | a) increased insurance coverage costs, b) a desire to better serve patients' needs & c) increased patient-initiated malpractice lawsuits |
| A practice in which the physician employs other physicians and pays them a salary is called | sole proprietorship |
| An associate practice is a legal agreement in which the physicians | share a faculty and staff |
| A business operation consisting of medical practice in which two or more physicians are responsible for the actions of each including debts, is called a/an | partnership |
| A medical practice consisting of three or more physicians who practice the same speciality and share expenses and income is a/an | group practice |
| The members of a professional corporation are known as | shareholders |
| Benefits of a corporation include all of the following except | protections from lawsuits for the corporation |
| Which form of medical practice ends with the death of the owner? | A solo practice |
| Fee splitting occurs when | one physician pays another physician for the referral of patients |
| Allied health professionals who are certified include all of the following except | pharmacists |
| A person with the appropriate education who practices as a doctor of medicine or doctor of osteopathy is called a/an | physician |
Created by:
mikeyjoesgirl