The characteristics of a medical expense or indemnity health insurance plan include deductibles, coinsurance requirements, stop-loss limits and maximum lifetime benefits. 2003-2023 Chegg Inc. All rights reserved. Some. C- Prospective review The term "managed care" is used to describe a type of health care focused on helping to reduce costs, while keeping quality of care high. Concepts of Managed Care MIDTERM HA95.docx, Test Bank Exam 1 Principles of Managed Care 012820.docx, 2 points Key common characteristics of PPOs do NOT include: Limited provider panels O Discounted payment rates Consumer choice O Utilization management Benefits limited to in-network care. The PPOs offer a wider. key common characteristics of PPOs include: A- Selected provider panels B- Negotiated payment rates C- Consumer choice & Utilization management D- All the above. IPAs: An IPA is the physician organization that contracts with HMOs on behalf of its member-physicians. Limited provider panels b. Bipolar disorder is a mental health condition in which a person shifts between mania, hypomania, and depression intermittently. The survey includes questions on the cost of health insurance, health benefit offer rates, coverage, eligibility, plan type enrollment, premium contributions, employee cost sharing . Oilwell_______b.Trademark_______c.Leasehold_______d.Goldmine_______e.Building_______f.Copyright_______g.Franchise_______h.Timberland_______i. Increasing use of percent coinsurance, especially for Tier 3 and Tier 4 specialty tiers when available.. Increasing number of consumer-directed health plan designs with higher front-end deductibles. Find the city tax on the property. extended inpatient treatment for substance abuse is clearly more effective, but too costly, T/F B- Capitation A broad and constantly changing array of health plans employers, unions, and other purchasers of care that attempt to manage cost, quality, and access to that care, Health plans with a Medicare Advantage risk contract only, The integral components of managed care are. Key common characteristics of PPOs include: selected provider panels negotiated payment rates consumer choice utilization management all of the above selected provider panels & negotiated payment rates & utilization management 10. \text{\_\_\_\_\_\_\_ d. Gold mine}\\ Patients C- Prepayment for services on a fixed, per member per month basis Service plans Compared to PPOs, HMOs cost less. D- Sliding scale FFS, what are the basic ways to compensate open-panel PCPs? The GPWW requires the participation of a hospital and the formation of a group practice.
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