Fill in the blanks with the correct terms from the word bank below.

Use the attached Word document to input your answers

Module 1 Assignment B

Your Managed Care Vocabulary

Assignment Instructions:

Fill in the blanks with the correct terms from the word bank below.

· gag rule

· health maintenance organization (HMO)

· preferred provider organization (PPO)

· diagnosis-related group (DRG)

· catastrophic cap

· individual mandate

· high-deductible health plan (HDHP)

· multi-payer system

· capitation

· universal coverage

· copayment

· single-payer system

· fee-for-service

1. A(n)                      establishes in advance what a funding agency will pay for specified procedures.

2. A patient with a managed care plan typically pays a(n)                      when he or she visits the doctor. 

3. A(n)                      plan qualifies members to establish tax-exempt health savings accounts. 

4. In a(n)                     system, patients and insurers pay the charges health care providers have established for the care they provide. 

5. A(n)                     typically hires health professionals, pays them a salary, and provides them with office and administrative support.
 

6. A(n)                     usually offers a discounted fee to health care professionals who treat patients  in their own offices.

7. Imagine that you have agreed to pay 20% of your medical expenses out of pocket and your medical bills are excessive. A(n)                      establishes the upper limit you will have to pay. 

8. If a health organization receives a set fee to care for a patient over a particular amount of time, regardless of how much care the patient requires, this is called                      . 
 

9. A(n)                     punishes managed care doctors for mentioning expensive treatments to patients. 

10. Assurance that all citizens will receive health services regardless of age, ability to pay, or any other factor is known as                _. 

11. In a(n)                   , one source, such as a government agency or national health insurance company, pays the bills for all essential health care services.

12. By contrast, in a(n)                   is one in which health insurance is provided by a variety of sources including private companies and government programs. 

13. The                     provision in the Affordable Care Act requires U.S. residents to maintain health insurance.