Key Terms
A licensed health care professional who receives reimbursement for providing health services.
What is a provider?
The year Medicare was established.
What was 1965?
HDHP stands for:
What is a High Deductible Health Plan?
Medicare provides insurance coverage for persons ___years and older who are eligible for Social Security benefits.
What is 65?
Choose _________ drugs whenever possible. Question expensive drugs or devices.
What is generic?
A method of reimbursement in which one payer, usually the government, pays all health care expensed for citizens; funded by taxes.
What is a single payer system?
DRGs stand for:
What is diagnosis-related groups?
HSA stands for:
What is a Health Savings Account?
Medicare provides health insurance to persons with end-stage _______ disease.
What is renal?
Alcohol and drug use, dietary habits, sedentary behaviors are all examples of ___________ choices.
What is lifestyle?
An organization other than the patient and the provider, such as an insurance company, that assumes responsibility for payment of health care charges.
What is a third-party payer?
The largest single payer of hospital charges.
Who is Medicare?
Member must select a physician from an approved list and must be referred by primary care physician for treatments, specialists, and services
What is a Health Maintenance Organization (HMO)?
CMS stands for ___________________________.
What is the Centers for Medicare & Medicaid Services?
Use the __________ to learn more about your health and preventing disease.
What is the Internet?
The uninsured and underinsured populations generate uncompensated or indigent care costs and bad debt for health care providers. Unpaid costs must be covered by those who do pay so the hospital can continue to operate. This a process known as:
What is cost shifting?
Also known as a retrospective payment system. The U.S. used this type of payment system in the past.
What is fee-for-service?
Member may select a physician or facility, but pays less for physicians and facilities on the plan's list.
What is a Preferred Provider Organization (PPO)?
The passage of this act in 2010 increased access to health care to the poor, the uninsured, and the uninsured.
What is the Patient Protection and Affordable Care Act (PPACA)?
Practice __________ health with health screenings and routine self-examinations.
What is preventive?
An online marketplace for individuals to shop for and purchase health insurance at affordable rates and to identify whether they qualify for cost assistance subsidies to help pay the cost of the insurance
What is the Health Insurance Exchange?
This type of payment system is based on DRGs. The U.S. uses this type of payment system presently.
What is a prospective payment system (PPS)?
The primary commonality among HMO, PPO, and POS plans is that they use some method to review and approve or deny the use of health care services. Collectively, these plans are known as:
What is Managed Care Organizations (MCOs)?
Health care coverage for low-income persons who are aged, blind, or disabled, and for certain families with dependent children
What is Medicaid?
Use emergency care only during ____________.
See your health care provider during
________ _______ .
What is "emergencies" and "office hours"?