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Chapter 2
Human Relations/Communications
Question | Answer |
---|---|
Who is considered the "father of medicine" | Hippocrates |
MCO | Managed Care Organization |
HMO | Health Maintenance Organization |
PPO | Preferred Provider Organization |
EPO | Exclusive Provider Organization |
Gatekeeper | Primary Care Physician- HMO, keeps cost of healthcare down |
POS | Point of Service Plan |
IPA | Independent Practice Association |
Solo Practice | MD owned - Only practioner |
Sole Proprietorship | MD owned hires other practioners. |
Group Practice | Three or more physicians share profit and loss Can consist of Partners and employees. |
Professional Corporation | Managed by Shareholders with Board of Directors Set up so that the Physician has minimal personal loss Hospitals, Urgent Care,Dr Offices owned by hospital |
Associate practice | Physicians agree to share expenses such as employee payroll, facility, general expenses, but profit and loss is their own. |
Concierge Medical Care | AKA "retainer medicine" patient pays an annual fee or retainer |
Health Maintenance Organization (HMO) | Healthcare services are made available to plan members for a predetermined fee or capitation rate- use a limited group of providers. PCP(Primary Care Physician – serves as gatekeeper. No copay or very Low |
Preferred Provider Organization | No gatekeeper Can go out of network for an additional fee Copay |
Exclusive Provider Organization | Combination of HMO and PPO concepts Providers limited to defined group Paid on modified fee- for- service |
Holistic Medicine | Medical doctors of holistic medicine are usually DO Focus on physical, mental, and social well-being of the “whole” person |
DO | Doctor of Osteopathy |
Point of Service | Contracts with independent providers at a discounted rate. Members have a choice at the time service is rendered of receiving services from an HMO, PPO, or fee-for-service plan. |
Fee for Service | Arrangement in which either the physician’s office or the patient files a claim to the insurance company, and the full amount allowed by the insurance company is collected. |