Chapter 27 & 28 Exam Questions and Answers
Flexible spending arrangement - Answer-referred to as a cafeteria plan
gatekeeper - Answer-term given to primary care providers because they are responsible for coordinating the patient's care to specialists, hospital admissions, and so on
fee sche...
Chapter 27 & 28 Exam Questions and
Answers
Flexible spending arrangement - Answer-referred to as a cafeteria plan
gatekeeper - Answer-term given to primary care providers because they are responsible
for coordinating the patient's care to specialists, hospital admissions, and so on
fee schedule - Answer-a list of predetermined payment amounts for professional
services provided to patients
___ is a system of health care that integrates the delivery and payment of health care
for covered persons (patients, or subscribers) by contracting with selected providers for
comprehensive health care services at a reduced cost. - Answer-Managed care
What type of insurance plan typically has high deductibles and lower monthly
premiums? - Answer-Consumer-driven health plans
Medicare - Answer-a federal program for providing health care coverage for individuals
over the age of 65 or those who are disabled
Medigap - Answer-private insurance to supplement Medicare benefits for payment of
the deductible, copayment, and coinsurance.
Medicaid - Answer-a joint funding program by federal and state governments (excluding
Arizona) for the medical care of low-income patients on public assistance
independent practice association - Answer-an association of independent physicians, or
other organization that contracts with independent physicians, and provides to managed
care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-
for-service basis
waiver - Answer-a document outlining services that will not be covered by a patient's
insurance carrier and the cost associated with those services
subscriber - Answer-the person who has been insured; the policy holder
third-party reimbursement - Answer-a phrase coined to indicate payment of services
rendered by someone other than the patient
third-party liability - Answer-refers to the legal obligation of third parties to pay or all of
the expenditures for medical assistance furnished under a state plan
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