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Chapter 2

Human Relations/Communications

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.
Created by: Tonedeoliveira



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