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Physicians are employees of the HMO and paid a salary
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the HMO contracts with at least two groups medical practices described as in network 2
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independent practice Association Lernen beginnen
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Marcus the health plan Physicians contract with the IPA to treat members of HMO
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preferred provider organization PPO Lernen beginnen
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a delivery Network that manages and negotiate contracts on behalf of the providers
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Health maintenance organizations HMO Lernen beginnen
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a professional who calculates insurance and annuity risks premiums and dividends
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exclusive provider organizations EPO Lernen beginnen
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delivery Network inwhich patients must use the services of those provided
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the out-of-pocket expense you pay the doctor
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the amount of money the insurer paid before the insurance company will pay
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Blue Cross Blue Shield known as subscribers rather than policyholders
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the price paid by the insured for insurance coverage
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payment method under which each patient is entitled to receive a set dollar amount of services in each time period
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determined by whether a provider normally charges for that service
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based on fee charged buy similar providers within geographic area
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any special circumstance of this accident
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cobra. consolidated Omnibus budget reconciliation Act Lernen beginnen
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provides that the employee may continue to be insured through employer plan even after being fired. employee picks up total cost
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ERISA. Employee Retirement income Security Act Lernen beginnen
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Federal legislation the mandates how employer funded benefit plans must be in administered
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if a service is covered under more than one policy then the insurance companies determine who pays
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insurance company, government, and Managed Care Organization
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all types of health plans in which fixed payments are made before services are rendered
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Insurance requires that certain procedures be authorized by the insurer before they are performed. failure will result in denial of claim
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process of restricting access to services
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what is the uninsured statistic Lernen beginnen
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45.7 million people or 17% without insurance
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one-party is exempt from incurred liabilities by the other party
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employer pays for Employees Healthcare
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companies that manages the paperwork for an employer who establishes a self insured plan
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describes the combination of payment for Healthcare and delivery of services into one system
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what did Blue Cross Blue Shield originally cover Lernen beginnen
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they prepaid Baylor University 2 hospitalized for 21 days. a group of teachers
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what does a self-insuring employer do Lernen beginnen
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the employer pays for Employees Healthcare
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what percentage of Americans are covered by some type of insurance Lernen beginnen
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