Exam (elaborations)
RMIN 4000 UGA Brown Test 4/Questions with Answers
- Course
- Institution
RMIN 4000 UGA Brown Test 4/Questions with Answers
[Show more]
Content preview
RMIN 4000 UGA Brown Test4/Questions with Answers
fee-for-serive - -a separate fee is paid for each service
- copayment - -flat amount the insured must pay each time health services
are received
- calendar year deductible - -an aggregate deductible that has to be
satisfied only once during the calendar year
- coinsurance - -the percentage of the medical expenses the policyholder
must pay in addition to the deductible amount
- Out-of-pocket maximum (stop-loss limit) - -the most the insured will have
to pay out-of-pocket in a calendar year
- managed care plan - -a health care plan that is designed to lower costs for
both the insurer and the consumer while maintaining a high standard of care
- health maintenance organization (HMO) - -system that provides
healthcare to its members on a prepaid basis in a particular area
- capitation fee - -a fixed annual payment for each plan member regardless
of the frequency or type of service provided
- advantages of HMO - -low cost sharing, good communication between
providers
- disadvantages of HMO - -no out of network coverage, must get referrals
- preferred provider organizations (PPO) - -plan that contracts with
healthcare providers to provide certain medical services at discounted fees
- advantages of PPO - -no referral needed, can see out of network providers
- disadvantages of PPO - -more cost-sharing, less efficient communication,
more complicated billing
- point of service plan (POS) - -hybrid of HMO and PPO
- consumer directed health care plan (CDHP) - -plan that combines a high-
deductible plan with a health savings account
, - health savings account (HSA) - -tax exempt account established
exclusively for the purpose of lying medical expenses - high deductible plans
only
- flexible spending account (FSA) - -permits employees to pay for certain
unreimbursed medical expenses with before tax dollars - cannot be used
with high deductible plan
- long-term care insurance - -pays a daily/monthly benefit for medical or
custodial care received in a nursing facility, hospital, or at home
- disability-income insurance - -provides income payments when the
insured is unable to work because of sickness or injury
- total disability - -inability to perform the material and substantial duties of
your regular occupation
- partial disability - -you can perform some but not all of the duties of your
occupation
- residual disability - -applies when you are gainfully employed and not
totally disabled but, solely because of sickness or injury, our loss of income is
at least 15 percent of your prior income
- dental insurance - -pays the cost of norma dental care, orthodontics not
usually covered
- vision insurance - -coverage for routine eyesore, usually does not cover
the full cost of glasses or contacts
- types of legal wrongs - -crime, breach of contract, tort
- tort - -a legal wrong for which the court allows a remedy in the form of
monetary damages
- 3 categories of tort - -intentional, strict liability, negligence
- intentional tort - -intentional act or omission resulting in harm or injury to
another person or damage to their property
- strict liability - -liability imposed regardless of negligence or fault (ex:
defective products, workers comp)
- negligence - -failure to exercise the standard of care required by law to
protect others from an unreasonable risk of harm
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Nursephil2023. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
85169 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now