Healthcare-Quiz

Organizations that finance or reimburse the cost of healthcare services are known as

• Payors

• Purchasers

• Providers

• Members

Individuals and entities that provide healthcare services, such as physicians, nurses, hospitals, and laboratories are known as

• Purchasers

• Providers

• Payors

• Members

Organizations or individuals that pay the premiums for healthcare plan, such as employers, and individual insureds are known as

• Payors

• Providers

• Purchasers

• Members

Individuals who are enrolled in a health plan, and for whom the health plan provides healthcare services are known as

• Providers

• Payors

• Purchasers

• Members

What goals do all health plans share?

• Member growth and profitability.

• Cost-effectiveness and profitability.

• Accessibility, cost-effectiveness, and quality.

• Quality and accessibility.

Carla pays a flat $20 fee to her doctor for an office visit, regardless of the cost of the services she receives. This is

• a copayment

• coinsurance

• a deductible

• both a copayment and coinsurance

Dan pays the first $1000 of his healthcare expenses each year, after which his health plan begins paying benefits. This is

• a copayment

• a coinsurance

• both a copayment and coinsurance

• a deductible

Primary Care Physicians (PCPs) are typically involved in

• Specialty care.

• Preventive care only.

• Just the treatment of routine illnesses and injuries.

• Prevention, treatment of routine conditions, and care coordination.

Which means of distributing information to health plan members is declining?

• Letters and newsletters sent by mail.

• Websites.

• E-mail.

• Electronic newsletters.

In health plan member services, when are paper documents typically sent by mail?

• For a variety of everyday notifications and routine transactions.

• When required by regulations for important notifications.

• To answer routine questions and requests.

• For any issue involving members age 55 and over.