Poly Med Ethics Review Question Back of Chap 4

Poly  Med Ethics Review Question Back of Chap 4

49 cards   |   Total Attempts: 188
  

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Cards In This Set

Front Back
Associate practice
Physicians agree to share expenses of a facility
a legal agreement in which physicians agree to share a facility and staff but do not, as a rule, share responsibility for the legal actions of each other (4)
Capitation rate
A fixed monthly fee paid by an HMO to health care providers for providing medical services to patients who are members of that HMO (4)
Certification
A voluntary credentialing process usually offered by a professional organization (40
Copayment
An agreed upon fee paid by the insured for certain medical services; usually $10 to $20 (4)
Corporation
A a type of medical practice, as established by law, which is managed by a board of directors
Diagnostic related groups ("DRGs)
Designations used to identify reimbursement ;per condition in a hospital ; used for Medicare patient
Exclusive provider organization (EPO)
Exclusive provider organization
a type of managed care that combines the concepts of the HMO and PPO
Fee splitting
An agreement to pay a fee to another physician or agency for the referral of patients this illegal in some states and is considered to be an unethical medical practice
Fixed payment plan
A payment plan for medical bills that offers subscribers (members) complete medical care in return for a fixed monthly fee
National :Practitioner Data Bank (NPDB)
A listing of names that assists with peer review of physicians
Franchise
A business run by an individual to whom a franchisor grants the exclusive right to market a product or service in a certain market area
Gatekeeper
The person, such as a primary care physician, aor entity, such as an insurance company, that approves patient referrals to other physicians or services.
Group practice
Three or more physicians who share the same facility and practice medicine together
Health Care Quality Improvement Act
Provides for peer review of physicians by other physicians and by other physicians and healthcare professionals
Health maintenance organization (HMO)
Health maintenance organization
a type of managed care plan that offers a range of health services to plan members for a predetermined fee per member by a limited group of providers