« previous next »

Author Question: A client has a private insurance policy that pays for most health care costs and services. Why is ... (Read 63 times)

erika

  • Hero Member
  • *****
  • Posts: 522
on: Jul 23, 2018
A client has a private insurance policy that pays for most health care costs and services. Why is this plan called a third-party payer?
 
  A) The insurance company pays all or most of the costs.
  B) The family of the client is required to pay costs.
  C) The client gets the bill and pays out-of-pocket costs.
  D) Medicare and Medicaid will pay most of the costs.

Question 2

Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs?
 
  A) Locally supported health care financing, usually by donations
  B) A public assistance program for low-income individuals
  C) Predetermined payment for services based on medical diagnoses
  D) A private insurance plan for subscribers who pay a copayment


johnharpe

  • Sr. Member
  • ****
  • Posts: 338
Reply #1 on: Jul 23, 2018
Answer to Question 1

Ans: A
Insurance for health care may be financed through private insurance, in which members pay a monthly premium. These plans are called third-party payers, because the insurance company pays all or most of the cost of care.

Answer to Question 2

Ans: C
Medicare, based on DRGs, pays a hospital a fixed amount that is predetermined by the medical diagnosis or specific treatment rather than by the actual cost of hospitalization and care. This plan was put into effect in an effort to control rising health care costs. It is not supported by donations; it is not a public assistance program or a private insurance plan.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
« previous next »
 

Did you know?

Sperm cells are so tiny that 400 to 500 million (400,000,000–500,000,000) of them fit onto 1 tsp.

Did you know?

The U.S. Preventive Services Task Force recommends that all women age 65 years of age or older should be screened with bone densitometry.

Did you know?

There used to be a metric calendar, as well as metric clocks. The metric calendar, or "French Republican Calendar" divided the year into 12 months, but each month was divided into three 10-day weeks. Each day had 10 decimal hours. Each hour had 100 decimal minutes. Due to lack of popularity, the metric clocks and calendars were ended in 1795, three years after they had been first marketed.

Did you know?

Malaria mortality rates are falling. Increased malaria prevention and control measures have greatly improved these rates. Since 2000, malaria mortality rates have fallen globally by 60% among all age groups, and by 65% among children under age 5.

Did you know?

During the twentieth century, a variant of the metric system was used in Russia and France in which the base unit of mass was the tonne. Instead of kilograms, this system used millitonnes (mt).

Nursing care principles for care Nursing care principles for care
Patient teaching: health promotion to prevent osteroporosis in women Patient teaching: health promotion to prevent osteroporosis in women
Development encompasses both gains and losses. Sometimes a health crisis (loss) can result in a heal Development encompasses both gains and losses. Sometimes a health crisis (loss) can result in a heal
After the death of a loved one, family members report concerns about last place of care. After the death of a loved one, family members report concerns about last place of care.
Common Physical and Mental Health Problems of Different Cultural Groups Common Physical and Mental Health Problems of Different Cultural Groups
Get Fit, Stay Well! Brief Edition Plus Mastering Health Get Fit, Stay Well! Brief Edition Plus Mastering Health
Video: Introduction to Sickle Cell Anemia

For a complete list of videos, visit our video library