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HIT 130 Quiz1 Review

Chapters 1& 2

QuestionAnswer
A practice with 10 or more physicians would generally be categorized as a(n) _________. large-group practice
Most hospitals today are owned by a(n) __________ . corporation
True or false? A small group practice will frequently contract out its billing and accounts receivable. True
The position that manages the coding of diagnoses, procedures, and services. medical coder
The position that handles administrative duties and is responsible for making a physician's office function smoothly. medical office assistant
The position that is responsible for answering questions or explaining such topics as privacy regulations and living wills to patients and their family members. privacy compliance officer
The position that obtains precertification and/or prior authorization of services. insurance verification representative
The position that manages the coding of diagnoses, procedures, and services. medical coder
The position that handles administrative duties and is responsible for making a physician's office function smoothly. medical office assistant
The position that is responsible for answering questions or explaining such topics as privacy regulations and living wills to patients and their family members. privacy compliance officer
The position that obtains precertification and/or prior authorization of services. insurance verification representative
The position that reviews records for completeness, accuracy, and compliance with regulations. registered health information technician
The position that submits insurance claims and enters patient data and charge information. medical biller
Utilization guidelines are used to: determine if services are medically necessary.
The three major concerns regarding healthcare in the United States are access to care, healthcare costs and _________. quality of care
Which type of statement is signed by the patient to authorize his or her insurance company to send payments directly to the provider? Assignment of benefits
The type of managed care plan that hires the physicians and pays them salaries. staff model health maintenance organization (HMO)
The type of health maintenance organization (HMO) that does not require a referral from a PCP to see a specialist. open access health maintenance organization (HMO)
The type of managed care plan that combines the features of health maintenance organization (HMO) and preferred provide organization (PPO) plans. point-of-service (POS) plan
The type of plan that pays benefits only for services provided by network providers but does not have a health maintenance organization (HMO) license. exclusive provider organization (EPO)
A type of HMO in which the MCO contracts with individual physicians and facilities to build the provider network. individual practice association (IPA) health maintenance organization (HMO)
The type of managed care plan in which members have financial incentives, such as lower copayments, when they obtain care from network providers. preferred provider organization (PPO)
The fixed dollar amount a member pays at each office visit or hospital encounter is called the ________ copayment
The portion of the provider's fees that the patient has to pay is known as the _____________. coinsurance
An insurance identification card usually includes name of the insurance policy or health plan, name of the subscriber, insurance policy number
What is managed care? a method to control healthcare costs and monitor and improve the quality of care provided to members.
Network of healthcare organizations under a parent holding company. Integrated Delivery System (IDS)
Created by: Prof Clark
 

 



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