Busy. Please wait.
Log in with Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password

Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't Know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Health Insurance

HI chp 3

This defines employer contributions and asks employees to be more responsible for healthcare decisions and cost-sharing. CDHP: Consumer-directed Health Plan
List two ways that MCOs impact a practice's administration. Pages 53 and 54 in textbook
Who is responsible for supervising and coordinating healthcare services for enrollees and approves referrals to specialists and inpatient hospital admissions? Primary care provider
This is a private, not-for-profit organization that assesses the quality of managed care plans in the US and releases the data to the public for consideration when selecting a managed care plan. NCQA: National Committee for Quality Assurance
This plan allows participants to enroll in a relatively inexpensive high-deductible insurance plan and a tax-deductible savings account is opened to cover current and future medical expenses. HSA: Health saving account
What is the term when the PCP provides essential healthcare services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists. Gatekeeper
What does the acronym EPO mean? Exclusive Provider Organization
What does the acronym IDS mean? Integrated Delivery System
What does the acronym HMO mean? Health Maintenance Organization
What does the acronym POS mean? Point-of-service Plan
What does the acronym PPO mean? Preferred Provider Organization
What does the acronym PCP mean? Primary Care Provider
This is a review of the appropriateness and necessity of care provided to patients prior to administration of care. Prospective review
This is a review of the appropriateness and necessity of care provided after administration of care. Retrospective review
This is a review for medical necessity of tests and procedures ordered during an inpatient hospitalization. Concurrent review
What reimburses providers for individual healthcare services rendered? Fee-for-service
What is it called when a provider accepts pre-established payments for providing healthcare services to enrollees over a period of time? Capitation
What are payments made directly or indirectly to healthcare providers to encourage them to reduce or limit services? Physician incentives
What is needed prior to scheduling elective surgery? That is, a second physician is asked to evaluate the necessity of surgery. SSO: Second Surgical Opinion
What in a managed-care contract would prevent providers from discussing all treatment options with patients? Gag clause
What is a voluntary process that a healthcare facility or organization undergoes to demonstrate that it has met standards beyond those required by law? Accreditation
Created by: YTIMBC
Popular Insurance sets




Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
restart all cards