Deck 3: Working in Health Care

Question 1

Under this concept, a patient is established with a physician in a primary care group practice that provides a long-term partnership between the patient and providers in the group practice and also provides enhanced access for patients.

A) health maintenance plan
B) primary care medical home
C) patient-centered medical home
D) independent practice home
E) open access plan

Answer 1

patient-centered medical home

Question 2

A copayment is

A) a percentage of the fee for services provided that the patient pays.
B) a set amount that each patient pays for each office visit.
C) a portion of the fee that the physician must write off.
D) the actual payment the insurance company makes to the provider.
E) a capitation payment.

Answer 2

a set amount that each patient pays for each office visit.

Question 3

The statutes in all 50 states that govern the practice of medicine are called:

A) medical practice acts
B) medical licensing acts
C) occupational statutes
D) physician licensing acts
E) national board of medical licensing

Answer 3

medical practice acts

Question 4

Under this type of plan, a patient may see providers outside the plan, but the patient pays a higher portion of the fees.

A) health maintenance plan.
B) indemnity plan.
C) fee for service plan.
D) preferred provider plan.
E) open access plan.

Question 5

A valid out-of-state license is accepted as the basis for issuing a license in a second state without reexamination. This is called:

A) certification
B) accreditation
C) registration
D) reciprocity
E) endorsement

Question 6

Which of the settings below provides limited liability for the providers?

A) associate practice
B) partnership
C) sole proprietorship
D) group practice
E) professional corporation

Question 7

A new long-term care facility is applying for accreditation of the facility. To which of the following organizations should the facility submit the accreditation application?

A) the American Health Care Association
B) the National Committee for Quality Assurance
C) The Joint Commission
D) the Commission on Accreditation of Allied Health Education Programs
E) the National Association for the Support of Long Term Care

Question 8

Coinsurance is

A) a percentage of the fee for services provided that the patient pays.
B) a set amount that each patient pays for each office visit.
C) a portion of the fee that the physician must write off.
D) the actual payment the insurance company makes to the provider.
E) a capitation payment.

Question 9

Most medical training is provided in tertiary care settings. Which of the following is an example of a tertiary care setting?

A) physician's office
B) trauma center
C) mobile clinic serving migrant workers
D) community health care clinic
E) walk in clinic

Question 10

Which practice management system allows for a sharing of expenses without sharing profits and liability?

A) associate practice
B) partnership
C) sole proprietorship
D) group practice
E) corporation

Question 11

A health care provider is explaining to staff members about the accreditation process. Which of the following may be accredited?

A) a pharmacist
B) a hospital
C) a pharmaceutical company
D) a pharmacy
E) a medical supply company

Question 12

A method used by a health plan to measure the amount and appropriateness of health services used by its members is called a(n)

A) coinsurance review.
B) capitation review.
C) accountable care review.
D) formulary review.
E) utilization review.

Question 13

Insured patients must designate a primary care provider (PCP) under which type of plan?

A) indemnity plan
B) point-of-service plan
C) preferred provider plan
D) independent practice plan
E) open access plan

Question 14

Medical practices are being consolidated in many forms. Which of the following is not one of those forms?

A) associate practice
B) partnership
C) sole proprietorship
D) group practice
E) corporation

Question 15

Which of these credentials is mandatory for certain health professionals to practice in their field?

A) certification
B) accreditation
C) registration
D) reciprocity
E) licensure

Question 16

Which of the following credentials is a voluntary, national examination that shows the level of competency for an individual?

A) certification
B) accreditation
C) registration
D) reciprocity
E) endorsement

Question 17

Both Doctors of Medicine (MDs) and Doctors of Osteopathy (DOs) follow requirements to obtain a degree in their field. Which of the following is the basic difference between these two degrees?

A) MDs require more years of training to complete the program.
B) DOs require more years of training to complete the program.
C) DOs are not allowed to prescribe drugs.
D) MDs are not allowed to practice surgery.
E) MDs are trained in allopathic medicine.

Question 18

When physicians, hospitals, and other health care providers contract with one or more HMOs or directly with employers to provide care, it is called a(n)

A) health maintenance plan.
B) physician hospital organization.
C) fee-for-service plan.
D) indemnity plan.
E) open access plan.

Question 19

Which of the following is not sufficient grounds for revoking a medical license?

A) conviction of a felony
B) falsifying medical records
C) misdiagnosis
D) personal incapacity
E) unprofessional conduct

Question 20

A physician is entering a residency to complete her education. Which of the following accurately describes this process?

A) a period of practical postgraduate training in a nursing home
B) a three-year period of training as an intern
C) a period of practical postgraduate training in a hospital
D) a four-year process that certifies the physician as a NBME Diplomate
E) a one-year period of training as an intern

Question 21

What federal legislation created health insurance exchanges that provide individuals with an ability to purchase insurance?

A) Health Insurance Portability and Accountability Act
B) Health Care and Education Reconciliation Act
C) Healthcare Integrity and Protection Data Bank Act
D) Patient Protection and Affordable Care Act
E) Health Care Quality Improvement Act

Question 22

What is the difference between licensure and certification?

Question 23

The most popular mobile medical app function is

A) exercise programs.
B) general medical reference.
C) drug references.
D) billing information.
E) diagnostic support.

Question 24

As a provision of the Accountable Care Act, health care insurers were encouraged to unite with health care providers to form what type of an organization?

A) health maintenance organization
B) preferred provider organization
C) open access plan
D) accountable care organization
E) indemnity plan

Question 25

Under the provisions in the Affordable Care Act, insurance companies must cover dependent children up to age ___.

A) 22
B) 23
C) 24
D) 25
E) 26

Question 26

What federal legislation provided employees the ability to keep health insurance coverage when transferring to another job?

A) Health Insurance Portability and Accountability Act
B) Health Care and Education Reconciliation Act
C) Healthcare Integrity and Protection Data Bank Act
D) Patient Protection and Affordable Care Act
E) Health Care Quality Improvement Act

Question 27

When two or more physicians decide to practice individually, what is this type of practice known as?

Question 28

A patient portal is

A) online access to a variety of health care services and communications with providers.
B) an educational program for patients.
C) an educational program for providers.
D) a medical device to provide nutrients to patients.
E) an educational program for family members of dying patients.

Question 29

A physician is undergoing professional peer review related to an incident of fraud in his practice. Which federal law requires that professional peer review action be taken in this case and also limits the damages for the professional review?

A) Health Care and Education Reconciliation Act
B) Health Insurance Portability and Accountability Act
C) Healthcare Integrity and Protection Data Bank Act
D) Patient Protection and Affordable Care Act
E) Health Care Quality Improvement Act

Question 30

Health insurance that covers the insured against a potential loss of money from medical expenses resulting from an illness or accident is known as:

Question 31

Facebook, Twitter, and blogs are examples of

A) wikis
B) discussion sites
C) social media
D) telemedicine
E) closed-circuit television

Question 32

The National Practitioner Data Bank may disclose information to which of the following groups?

A) medical malpractice insurers
B) defense attorneys
C) state licensing boards
D) the general public
E) state legislators

Question 33

A remote consultation with physicians or other health care professionals is called

A) social media.
B) patient monitoring.
C) open access.
D) telemedicine.
E) closed-circuit television.

Question 34

The term that refers to a process for officially authorizing or approving health care practitioners, education programs, health care facilities, and managed care plans is called: