Plan Types
_____ is a kind of health insurance that has a list of providers, such as doctors, medical groups, hospitals and labs.
What is HMO?
How many Health plans is Cedars Sinai contracted with?
What is 30+?
What does PMPM stand for?
What is Per member per month?
It combines characteristics of the health maintenance organization and the preferred provider organization.
What is POS?
What is check eligibility and Authorization?
A tool used by health plans and medical groups to define which party is financially responsible for services rendered.
___ is Medicare's managed care program.
What is Medicare Advantage?
No Auth?
What is no payment?
A way of paying healthcare providers or organizations-they receive a predictable, upfront, set amount money to cover cost of all or some of the services rendered over a period of time.
What is Capitation?
Do we accept Low-cost state subsidized?
What is Medi-Cal?
Healthcare claims are paid upfront, and then potential errors, overpayments, or fraudulent claims are "chased down" after payment has been made.
What is pay and chase?