Patient Care Chapter 4

Question 1

Under this system, insurance companies reimburse patients for the costs of their health care within the limits of the policy, and the patient is responsible for any costs not covered

Answer 1

fee-for-service

Question 2

These organizations provide complete and comprehensive health care for the cost of the premium and a small fee called a copayment for each visit.
- control costs by promoting good health and by providing care in specified facilities only

Answer 2

health maintenance organizations (HMO)

Question 3

what are the advantages of HMO’s?

Answer 3

reduce the average cost of health care for all its members

Question 4

what are the benefits of an HMO?

Answer 4

• regular physical exams
• immunizations
• weight control
• treatment for hypertension
• fitness programs
• classes on health related topics

Question 5

These systems allow private hospitals and physicians to provide private services while also providing care through insurance plans that operate as HMOs or PPOs

Answer 5

managed care systems

Question 6

a system that offers care at reduced rates within an established network of providers

Answer 6

PPO or preferred provider organization

Question 7

open for extended hours and see patients on a walk-in basis