HAP%20301-Quiz%20#5answers

HAP%20301-Quiz%20#5answers - HAP 301 Fall 2010...

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November 22, 2010 HAP 301 – Fall 2010 Quiz #5 (chapters 9 and 10) 1. What type of reimbursement method (provider payment) involves a fixed monthly sum per enrollee? a. Fee for Service b. Capitation c. Service Fee Schedule d. MCO 2. One aspect in which managed care differs from conventional insurance: a. Collection of premiums b. Assumption of risk for beneficiaries c. Direct delivery of services d. Making payments to providers 3. PRE-certification is associated with which type of utilization review? a. Concurrent b. Prospective c. Gatekeeping d. Retrospective 4. What was the main factor that differentiates the various types of MCOs? a. Provider payment and network b. Cost to employers c. Delivery arrangements d. Malpractice premiums 5. Which type of HMO model employs its own salaried physicians? a. Staff b. Management c. Risk d. Network 6. Which of the following is NOT a characteristic of PPO plans? a.
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HAP%20301-Quiz%20#5answers - HAP 301 Fall 2010...

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