What are the four classifications of hospitals based upon the source of income received?
Private or proprietary (for profit), religious, nonprofit or voluntary and government
What is a residential care facility
Provides basic physical and emotional care also called nursing home or geriatric home
What type of care is provided at an extended care facility
Provides skilled skilled nursing care and rehabilitative care
What type of care is provided in a independent living facility
Individuals rent an apartment and provide them with meals, housekeeping, laundry and assist with medications
Identify 5 types of clinics
Surgical, urgent or emergency, rehabilitation, specialty, outpatient, health department or medical center
What is palliative care
Care that provides support and comfort and is directed toward allowing the person to die with dignity
How do nonprofit or voluntary agencies receive their funding
Donations, membership fees, fund-raisers and federal or state grants
What is a premium
Fee the individual pays for insurance coverage
What is a deductible
Amounts that must be paid by the patient for medical services before the policy begins to pay
Calculate the amount of money owed by the patient if they are on a 75%/25% coinsurance and their bill is $100
Insurance pays $ 75 and patient pays $ 25
Calculate the amount of money owed by the patient if they are on a 80%/20% coinsurance and their bill is $100
Insurance pays $80 and patient pays $20
What is a co-payment
A specific amount of money a patient pays for a particular service at each visit regardless of the total cost of the visit
Define a HMO
A insurance plan that provides a managed care plan for the delivery of health care services. Care directed toward preventive type health care
What is a PPO
Type of managed care insurance provided by large industries or companies, can only go to specific doctors or hospitals. Require deductible and a co-payment
What is one advantage of HMOs
Provides routine examinations and preventive care tries to maintain a better state of health
What is a disadvantage of HMOs
Required to use only HMO affiliated providers and if go out of network required to pay all costs
How can industry or company' s provide health care at lower rates
Use PPOs that require that specific hospitals or doctors be used
Who is covered by Medicare
All individuals over 65, person with a disability and receives social security for at least 2 years and endstage renal disease
Who is covered by Medicaid
Vary from state to state, low income, children who qualify for public assistance and those who are physically disabled or blind
The State Children's Health Insurance Program (CHIP) covers who?
Uninsured children of working families who earn too little to afford private insurance
Who qualifies for workers' compensation
Workers injured on the job
TRICARE provides health insurance for who?
Military personnel
What is the principle for managed care?
All health care provided must have a purpose, a second opinion is needed, provide preventive care, and early diagnosis, control costs and stay within network
What does an organizational structure provide
Provides a line of authority or chain of command
What is a clinic
Also called satellite clinic, they are a group of medical or dental doctors who share a facility and other personnel
What federal agency is responsible for regulating food and drug products
FDA - Food and Drug Administration
What type of care is provided by hospice
Provides care for terminally ill who usually have life expectancies of 6 months or less
What is another term for hospice
Palliative care
What are the four classifications of hospitals based upon the source of income received?
Private or proprietary (for profit), religious, nonprofit or voluntary and government
What is a residential care facility
Provides basic physical and emotional care also called nursing home or geriatric home
What type of care is provided at an extended care facility
Provides skilled skilled nursing care and rehabilitative care
What type of care is provided in a independent living facility
Individuals rent an apartment and provide them with meals, housekeeping, laundry and assist with medications
Identify 5 types of clinics
Surgical, urgent or emergency, rehabilitation, specialty, outpatient, health department or medical center
What is palliative care
Care that provides support and comfort and is directed toward allowing the person to die with dignity
How do nonprofit or voluntary agencies receive their funding
Donations, membership fees, fund-raisers and federal or state grants
What is a premium
Fee the individual pays for insurance coverage
What is a deductible
Amounts that must be paid by the patient for medical services before the policy begins to pay
Calculate the amount of money owed by the patient if they are on a 75%/25% coinsurance and their bill is $100
Insurance pays $ 75 and patient pays $ 25
Calculate the amount of money owed by the patient if they are on a 80%/20% coinsurance and their bill is $100
Insurance pays $80 and patient pays $20
What is a co-payment
A specific amount of money a patient pays for a particular service at each visit regardless of the total cost of the visit
Define a HMO
A insurance plan that provides a managed care plan for the delivery of health care services. Care directed toward preventive type health care
What is a PPO
Type of managed care insurance provided by large industries or companies, can only go to specific doctors or hospitals. Require deductible and a co-payment
What is one advantage of HMOs
Provides routine examinations and preventive care tries to maintain a better state of health
What is a disadvantage of HMOs
Required to use only HMO affiliated providers and if go out of network required to pay all costs
How can industry or company' s provide health care at lower rates
Use PPOs that require that specific hospitals or doctors be used
Who is covered by Medicare
All individuals over 65, person with a disability and receives social security for at least 2 years and endstage renal disease
Who is covered by Medicaid
Vary from state to state, low income, children who qualify for public assistance and those who are physically disabled or blind
The State Children's Health Insurance Program (CHIP) covers who?
Uninsured children of working families who earn too little to afford private insurance
Who qualifies for workers' compensation
Workers injured on the job
TRICARE provides health insurance for who?
Military personnel
What is the principle for managed care?
All health care provided must have a purpose, a second opinion is needed, provide preventive care, and early diagnosis, control costs and stay within network
What does an organizational structure provide
Provides a line of authority or chain of command
What is a clinic
Also called satellite clinic, they are a group of medical or dental doctors who share a facility and other personnel
What federal agency is responsible for regulating food and drug products
FDA - Food and Drug Administration
What type of care is provided by hospice
Provides care for terminally ill who usually have life expectancies of 6 months or less
What is another term for hospice
Palliative care