Answer to Question 1
ANS: 1
A preferred provider organization (PPO) is characterized by a contractual agreement between a set of providers (e.g., hospitals, physicians, or clinics) and a purchaser (e.g., the corporation's in-surance plan). Comprehensive health services are provided at a discount to the companies under contract. Enrollees are limited to a list of preferred hospitals, physicians, and providers. An enrollee pays more out-of-pocket expenses for using a provider not on the list.
A Medicare HMO is the same as a managed care organization (all care provided by a primary care physician) but designed to cover costs of senior citizens.
Private insurance is the traditional fee-for-service plan where payment is computed after services are provided based on the number of services used.
Third-party payment is when an entity (other than the client or health care provider) reimburses health care expenses. Third-party payers include insurance companies, governmental agencies, and employers.
Answer to Question 2
ANS: 1
Examples of health promotion activities include exercise classes, prenatal care, well-baby care, nutrition counseling, and family planning.
An immunization clinic is an example of an illness prevention service.
A diabetic support group may be an example of a rehabilitation service to adapt to a change in lifestyle.
Patients with physical special needs, such as a wheelchair, need to have this documented in their he
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