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Healthcare Management: An Introduction

Last Update Dec 22, 2024
Total Questions : 367

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Healthcare Management: An Introduction Questions and Answers

Questions 1

The Mabry County Hospital negotiated a contract with Wellfolk HMO. Mabry negotiated the inclusion of a provision in the contract whereby Mabry agreed to capitated compensation from Wellfolk up to a specified total cost of providing medical services for an

Options:

A.

quality assurance provision

B.

performance-based financial provision

C.

dual-choice provision

D.

stop-loss provision

Questions 2

Which of the following statements is FALSE?

Options:

A.

The license that HMOs get in each state is called ‘Certificate of Authority’

B.

The HMO contracts directly with the individual physicians who provide the medical services to the HMO members in a variation of the IPA model called direct contract model HMO.

C.

All medicare/mediclaim beneficiaries should comply with utilization management requirements set forth by HCFA

D.

HMO’s usually impose high coinsurance or deductible requirements

Questions 3

The Links Company, which offers its employees a self-funded health plan, signed a contract with a third party administrator (TPA) to administer the plan. The TPA handles the group's membership services and claims administration. The contract between Links

Options:

A.

a manual rating contract

B.

a funding vehicle contract

C.

an administrative services only (ASO) contract

D.

a pooling contract

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