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NHA Mod 1 Section 1 Foundational Knowledge

Authored by Angie Ayers

Health Sciences

9th - 12th Grade

Used 1+ times

NHA Mod 1 Section 1 Foundational Knowledge
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27 questions

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1.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

An umbrella term for plans that provide health care in return for preset scheduled payments and coordinated care through a defined network of providers and hospitals.

Managed care

Health maintenance organization (HMO)

Capitation

Preferred provider organization (PPO)

Point-of-service (POS) plan

2.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Pts are assigned a per-member, per-month payment based on age, race, sex, lifestyle, medical hx, & benefit design. Payment rates are tied to expected usage regardless of how often the pt visits. Like bundled payment models, providers are incentivized to help pts avoid high-cost procedures & tests to maximize their compensation.

Managed care

Capitation (partial or full)

Health maintenance organization (HMO)

Preferred provider organization (PPO)

Point-of-service (POS) plan

3.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

HMOs force you to pick a doctor from a list

TRUE

FALSE

4.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

If you have a managed health care plan, it means that you:

Usually must first meet with your primary health care physician

Can go to any doctor at any time

Will be responsible for $100 of a doctor bill

Can apply for an 80% reimbursement of the amount paid to the doctor

5.

MULTIPLE CHOICE QUESTION

1 min • 1 pt

Sally's health insurance policy requires her to pay the first $500 of medical costs each year before the company will pay any of her medical bills.  This policy provision is the:

Co-insurance clause
Premium
Annual deductible
Major medical benefit

6.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

Which is TRUE of health insurance?

you can only use only the doctors in your state

you might get a lower standard of care if you don't have insurance

you won't be able to go to a hospital without insurance

selecting in-network doctors instead of out-of-network doctors can save you money

7.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

A formal request from the customer to an insurance company asking for a payment based on the terms of the insurance policy

claim

premium

deductible

policy

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