Healthcare Facilities
Voluntary non-profit institutions are what?
A non profit organization exempt from taxes that provides benefits to the community.
In which ways are proprietary institutions different from Voluntary or Government funded institutions?
They get taxed and they are for-profit.
True or False: A deductible is a changeable amount you have to pay before your insurance covers your healthcare costs.
FALSE
Between an MRI, an X-ray, and a CAT scan, which one would most likely require pre-authorization?
MRIs
If you have multiple hospital bills to treat a single condition, what type of payment would be the best?
A Bundling payment
3 main types of institutions with explanations.
Voluntary – Nonprofit that doesn’t get taxed
Proprietary – For profit taxed by Local, State and Federal sources
Government – Funded using state and federal resources
Which of the three institutes (voluntary, proprietary and government) have the MOST hospitals?
Voluntary Not-for-Profit
Why are deductibles used?
To stop the insurance company from receiving a lot of small claims.
What is the term for when you have two or more acute medical conditions simultaneously?
Comorbidities
What do Medicare, Medicaid, and managed care plans use to determine payment for services?
DRGs
What are 2 government funded buildings (government institutions)?
Veterans Affairs hospitals, state mental hospitals, military treatment facilities, public/government funded hospitals, state rehabilitation facilities.
Any two answers from above are correct.
What are proprietary institutions?
They are for-profit facilities that are usually owned by a corporation. They must pay local, state and federal taxes.
What is the max that you could pay towards a deductible called?
An out-of-pocket maximum!
What are the two main divisions of the U.S. Department of Health and Human Services?
Centers for Disease Control and Prevention (CDC)
Food and Drug Administration (FDA)
What are DRGs?
Diagnostic Related Groups: Patients are assigned to “groups” based on their diagnosis, age, and other factors. Each DRG has a set price that Medicare will pay the hospital (to control hospital costs).
True or False: All hospitals are nonprofit.
False
What are voluntary nonprofit institutions?
A community facility that receives federal, state and local tax exemptions in exchange for providing a community benefit (must show that it is operated for a charitable purpose).
What is a Federally Qualified Healthcare Center?
A community based non-profit organization providing comprehensive primary care to medically underserved populations, regardless of insurance status or ability to pay.
What type of physician is usually a Gatekeeper? In other words, what is another name for gatekeeper?
A primary care physician (PCP)
In which types of accounts do your saved funds remain in your account after the year ends?
HSA
What type of hospitals pay their doctors from the revenue they earn from patient services, grants, and other sources?
Volunteer nonprofit institutions, nonprofit hospitals.
What is the institute that is both government funded and nonprofit?
Department of Veterans Affair
What is the term for the conditions that a patient arrives to the hospital with?
Pre existing Conditions
What is a Catastrophic Plan?
A plan that you can get when above the age of 25; has a high deductible and only used for emergencies.
Who is the United States Secretary of Health and Human Services?
DAILY DOUBLE!!
Robert F. Kennedy Jr.