Unit 1
Unit 2 Hospitals
Unit 3 Financing
Medicare
Insurance Terms
100
In the input --> process --> output diagram, where would TREATMENT fall?
Process
100
What is the traditional unit of measure used to determine the size of a hospital?
Bed Capacity
100
What is the name of the university that first started to give health insurance to their employees for 50 cents/month?
Baylor University
100
How old must you be in order to eligible for Medicare?
65 years or older
100
What are services called that are NOT COVERED by a health plan?
Exclusions
200
What type of physician provides routine care for chronic and acute diseases and is sometimes called a gatekeeper in managed care?
Primary Care/Family Physician
200
Hospitals approved to receive Medicare reimbursement have what type of regulation?
Certification
200
What are the 3 roles the government plays in health care?
Provider, Payer and Regulator
200
What year was Medicare enacted and under what piece of legislation?
The Social Security Act of 1965
200
Excluding the patient and health care provider, who is involved in the financing of medical services?
Third Party Payer/Health Plan
300
What is the type of a doctor of medicine who focuses on diagnosis and treatment?
Allopathic
300
How often does the Joint Commission survey an accredited hospital?
Every 3 Years
300
What does the acronym HIPAA stand for?
Health Insurance Portability and Accountability Act
300
What part of Medicare covers prescription drugs?
Part D
300
What is the periodic payment called that is required to keep an insurance policy active?
Premium
400
What is the most sensitive indicator of a nation's health status?
Infant Mortality Rates
400
Two or more hospitals owned, leased, sponsored or managed by a central organization is what?
Multi-Hospital System
400
In the HIPAA privacy legislation, the letters T-P-O stand for what?
Treatment, Payment and Operations
400
Medicare would be considered what type of financing of Health Care?
Public
400
The amount you pay for medical care after you have met your deductible is what? Typically the plan will pay 80% and you pay 20%.
Co-Insurance
500
What percent of the US workforce is employed in the Health Care field?
10%
500
Who has the ultimate responsibility for everything that happens within a hospital, including medical and nursing care?
Governing Board
500
What federal Government department controls and oversees all federal health-related programs?
Department of Health and Human Services
500
What financially supports the Medicare program (Part A)?
Federal withholding taxes
500
What health plan allows employees to receive medical care outside of their health plan network?
Point of Service Plans
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