HMO- HEALTH MAINTENANCE ORGANIZATION Flashcards
1
Q
HMO- 4 POINTS
A
- PREVENTIVE CARE
- SERVICE BASIS- BILL PAID DIRECTLY TO DOCTOR/ HOSPITAL
- INSURED HAS TO VISIT DOCTOR IN THEIR AREA
- PRE-PAID
2
Q
GROUP PRACTICE MODEL
A
GROUP OF DOCTORS IN ONE BUILDING
3
Q
OPEN PANEL
A
ANYONE WITH HEALTH INSURANCE AND BE SEEN
4
Q
CLOSED PANEL
A
ONLY INSURED IN HMO CAN BE SEEN
5
Q
STAFF MODEL
A
NON PROFIT, OWNED BY DOCTORS & STAFF
6
Q
INDEPENDENT PRACTICE ASSOCIATION MODEL-IPS
A
INSURED CAN CHOOSE THEIR OWN DOCTORS, PRIMARY CARE PHYSICIAN IS THE GATE KEEPER, GIVE REFERRALS
7
Q
CAPITATION FEE
A
LIMIT THE INSURANCE COMPENY WILL PAY DOCTORS TO CARE FOR THEIR CLIENTS
