A patient tells the nurse he is a member of an exclusive provider ...

[mmm]

A patient tells the nurse he is a member of an exclusive provider organization. This means:
 
  a. the patient has total choice of provider
  b. the organization functions under a dis-ease-oriented philosophy
  c. the fee is preset and prepaid
  d. the plan pays no benefit if the member is treated outside of the network

Question 2

The nurse provides care to patients in a managed care environment. This means:
 
  a. the goal is the delivery of services in the most cost-efficient manner
  b. access to care is not controlled
  c. cost of care is more
  d. preventive services are delivered by a specialist

[amy.lauersdorf90]

Answer to Question 1

D
Within an exclusive provider organization, the plan pays no benefit if the member is treated outside of the network. These types of organizations are usually regulated by state insurance laws.

Answer to Question 2

A
Managed care is a system of providing and monitoring care in which access, cost, and quality are controlled before or during the delivery of services. The goal of managed care is the delivery of services in the most cost-efficient manner possible. Managed care seeks to control costs by monitoring the delivery of services and restricting access to expensive procedures and providers.

[mmm]

Thank you!

[amy.lauersdorf90]

Always glad to help...