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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. |
Created by:
Tonedeoliveira
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