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IHS 122 Chapter 1 Quiz Review 100% Answered
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IHS 122 Chapter 1 Quiz Review 100% Answered
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IHS 122 Chapter 1 Quiz Review 100%Answered
access - ANSWER-The ability of a person to obtain health care services when needed
administrative costs - ANSWER-Costs that are incidental to the delivery of health
services. They are associated with the management of the financing, insurance,
delivery, & payment functions of health care. They include management of the
enrollment process, setting up contracts with providers, claims processing, utilization
monitoring, denials & appeals of claims, & marketing & promotional expenses
balance bill - ANSWER-The practice in which the provider bills the patient for the
leftover sum after insurance has only partially paid the charge initially billed
defensive medicine - ANSWER-Excessive medical tests and procedures performed as
a protection against malpractice lawsuits, & otherwise regarded as unnecessary
demand - ANSWER-The quantity of health care purchased by consumers based solely
on the price of those services
enrollee - ANSWER-A person enrolled in a health plan, especially a managed care plan
free market - ANSWER-A competitive market characterized by the unencumbered
operation of the forces of supply & demand & where numerous buyers and sellers freely
interact
global budgets - ANSWER-Allocation of pre-established total expenditures for a health
care system or subsystem
health care reform - ANSWER-In the U.S. context, expansion of health insurance to
cover the uninsured
health plan - ANSWER-The contractual arrangement between a managed care
organization & an enrollee, including the collective array of covered health services to
which the enrollee is entitled
managed care - ANSWER-A system of health care delivery that (1) seeks to achieve
efficiencies by integrating the four functions of health care delivery, (2) employs
mechanisms to control (manage) utilization of medical services, and (3) determines the
price at which the services are purchased & consequently, how much the providers get
paid
Medicaid - ANSWER-A joint federal-state program of health insurance for the poor
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