GE ELECT 4SSP Q.5

It describes the payment that hospital, healthcare provider, diagnostic facility, or other healthcare providers receive for giving you a medical service.

• Entrepreneurship system

• Collection system

• Payment system

• Healthcare reimbursement

Securing payment from a third party such as a government health system or insurance  company is a continuing struggle for nurses in independent practice.

• Entrepreneurship system

• Collection system

• Politics of payment

• Healthcare reimbursement

These payments may  be based on the type of service provided, or based on the type of provider. 

• fee for service systems

• manage care organizations

• capitated model

• reimbursement systems

This act as both providers and insurers, controlling both  utilization and payment.

• fee for service systems

• manage care organizations

• capitated model

• reimbursement systems

The provider accepts a flat fee per  patient/client or per-capita.

• fee for service systems

• manage care organizations

• capitated model

• reimbursement systems

These are are organizations that integrate financing  and delivery of health services by offering comprehensive care from an established panel of  providers to an enrolled population on a capitated, prepaid basis.

• fee for service systems

• manage care organizations

• capitated model

• Health Maintenance Organizations

In Canada, the  government health system does not reimburse nurses through provincial or territorial health  insurance plans; so most self-employed nurses are paid directly by these individuals.

• national health programs

• clients

• private health plans

• health maintenance organizations

In the United States, the American Nurses Association (ANA) first identified direct third party (i.e. _________) reimbursement for nursing services as a priority in 1948.

• Politics of payment

• Health Maintenance Organization

• health insurance

• government health system

The following are considered third party payment system, except:

• client

• government health system

• insurance  company

• private health plans

The health systems of many industrialized countries cover their entire populations either  through guaranteed entitlement or as an _______.

• privilege

• actionable right

• mission

• earned right