Deck 12: Business Aspects of Healthcare

Question 1

Which part of Medicare covers prescriptions?

A) A
B) B
C) C
D) D

Answer 1

D
Medicare Part D covers the prescription drug plan.

Question 2

This type of practice is a corporate structure, and shares in the overhead and personnel expenses.

A) Solo
B) Sole proprietorship
C) Associate practice
D) Group practice

Answer 2

D
A group practice has a corporate structure that assigns designated officers to manage the group, not only enabling the individual physicians to be covered when they are unavailable to see patients, but also enabling them to share overhead and staffing costs and personal protection from liability.

Question 3

A disadvantage to an HMO is:

A) they are too large.
B) some areas may not have a participating physician.
C) they give too many referrals to specialists.
D) you have to pay first, and then get reimbursed.

Answer 3

B
In some cases some people do not have access to the participating providers that are listed. Also, if the patient wants to see a physician who is not in the network, he or she would have to pay for those services completely on his or her own.

Question 4

This type of provider is not required to complete full medical school requirements.

A) MD
B) DO
C) Surgeon
D) OD

Question 5

If an insurance plan is 80/20, what is the term for this plan?

A) Point-of-service
B) HMO
C) PPO
D) Workers' compensation

Question 6

Which part of Medicare covers hospital claims?

A) A
B) B
C) C
D) D

Question 7

Medical coverage for persons 65 and older is called:

A) Medicaid.
B) Medicare.
C) Blue Cross/Blue Shield.
D) TRICARE.

Question 8

What is an advantage of incorporation?

A) Protection of assets
B) More availability as a physician
C) Access to all patients' medical records
D) All of the above

Question 9

Why must a healthcare professional wear an identifying badge at all times in a hospital?

A) Some people may mistake a mid-level practitioner with a physician.
B) Some people may try to fake being a physician.
C) Some people will try to gain entry by pretending to be a medical staff member.
D) Some people want access to medications for their own use.

Question 10

A person can be covered by both Medicaid and Medicare.

Question 11

Who can bill to insurance companies?

A) RNs
B) BSNs
C) LPNs
D) NPs

Question 12

The insurance used to cover military members and their families is called:

A) Medicaid.
B) Medicare.
C) Blue Cross/Blue Shield.
D) TRICARE.

Question 13

A physician owns a pharmacy down the street from his office, and refers patients there without disclosing that he owns it. The term for this is:

A) scamming.
B) unethical.
C) fee splitting.
D) patient pressure.

Question 14

A person is under the poverty level. What kind of insurance may he or she have?

A) Medicaid
B) Medicare
C) Blue Cross/Blue Shield
D) TRICARE

Question 15

This type of practice has a two or more providers that share in overhead, but do not share in the profits or losses.

A) Solo
B) Sole proprietorship
C) Associate practice
D) Group practice

Question 16

Government carriers include all of the following, except:

A) Medicaid.
B) Medicare.
C) Blue Cross/Blue Shield.
D) TRICARE.

Question 17

In this insurance plan, the patient chooses his or her provider and pays a flat fee to the provider.

A) Point-of-service
B) HMO
C) PPO
D) Worker's compensation

Question 18

This type of practice has physicians work for him or her, but still owns the practice.

A) Solo
B) Sole proprietorship
C) Associate practice
D) Group practice

Question 19

Allied health professionals include the following, except:

A) OT.
B) BSN.
C) CAN.
D) CPC.

Question 20

The providers are not physicians, but may perform similar services.

A) BSNs
B) CMTs
C) PAs
D) EMTs

Question 21

All physician assistants bill insurance companies for their services.

Question 22

An ERISA plan is a self-insured model.

Question 23

Medicine is a business.

Question 24

All specialists must have the same amount of education.

Question 25

All licensed physicians have undergone a minimum of undergraduate school and fully completed medical school and internship requirements beyond finishing medical school.