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2024 N104 UNIT 14, 15, 16, AND 17 FINAL EXAM WITH CORRECT ANSWERS
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2024 N104 UNIT 14, 15, 16, AND 17 FINAL EXAM WITH CORRECT ANSWERS
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2024 N104 UNIT 14, 15, 16, AND17 FINAL EXAM WITH CORRECT
ANSWERS
U16: What is PPS? - CORRECT-ANSWERSProspective Payment System: helps
reduce length of stay and amount of procedures performed for Medicare
patients
U16: What are Managed Care Organizations? - CORRECT-ANSWERS-used by
private insurance companies to manage the use of health services
- coverage can be denied
- goal is to minimize payment for inappropriate or excessive health services
U16: What does MCO stand for? - CORRECT-ANSWERSManaged Care
Organizations
U16: What are the 3 types of managed care organizations? - CORRECT-
ANSWERS1) HMOs
2) PPOs
3) POS
U16: What does HMO stand for? - CORRECT-ANSWERSHealth Maintenance
Organizations
-type of MCO
U16: What does PPO stand for? - CORRECT-ANSWERSPreferred Provider
Organizations
- type of MCO
U16: What does POS stand for? - CORRECT-ANSWERSPoint of Service plan
-type of MCO
U16: What is cost shifting? - CORRECT-ANSWERSwhen unpaid costs from
underinsured or uninsured patients are covered by those who do pay --- this
leads to increased insurance premiums
U16: What is Medicaid? - CORRECT-ANSWERSa federal and state joint health
insurance plan for the poor
, U16: What is the Patient Protection and Affordable Care Act? - CORRECT-
ANSWERS- provides affordable health insurance options through an
insurance marketplace
- requires US citizens/legal residents to have a qualifying health insurance
coverage or pay a penalty
- addresses many issues including employer requirements, health insurance
exchanges, and prevention and cost-reduction approaches
U16: What lead to the creation and passage of the PPACA? - CORRECT-
ANSWERScost- shifting, uncompensated care, and lack of access to health
care
U16: What are the 2 types of paying for health care - CORRECT-ANSWERS1)
private insurance
2) public insurance
U16: List the types of public insurance - CORRECT-ANSWERS1) Medicare
2) Medicaid
3) Veterans Administration
U16: List the 3 parts of Medicare - CORRECT-ANSWERSA: covers hospital
stays and home health
B: covers doctor's services
D: covers prescriptions
Unit 14: Teams - CORRECT-ANSWERS- a group of people organized to
accomplish the necessary work of an organization
- a range of people brought together to meet customer needs, accomplish
tasks, and solve problems
Unit 14: List the different types of team members in healthcare - CORRECT-
ANSWERS- unit secretaries
- nursing assistants
- social workers
- dietitians
- therapist
- physicians
- LPN/LVN
- nurses
- physical therapists
- occupational therapists
- social workers
- pharmacists
- PAs
- speech language pathologist
- respiratory therapists
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