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For Each of the Following Definitions, Indicate the Key Term

Question 46

Essay
For each of the following definitions, indicate the key term from the list that best matches by placing the appropriate definition.
A. Contractual adjustments
B. Capitation fees
C. Charity care
D. Diagnosis-related groups
E. Prospective payment system
F. Health maintenance organizations
G. Performance indicator
H. Third-party payor
________ 1. A prepaid health care plan that functions as a broker of health care between the
consumer/patient requiring services and the health care provider
________ 2. Medicare's system in which payments are based on allowed service costs within the
same diagnosis-related group rather than on actual cost of services rendered
________ 3. Fixed dollar amount of fees per person paid periodically by a third-party payor to a
health care provider
________ 4. The difference between the gross patient service revenue and the negotiated payment by
third-party payors in arriving at net patient service revenue
________ 5. Health services provided to persons with a demonstrated inability to pay

For each of the following definitions, indicate the key term from the list that best matches by placing the appropriate definition.
A. Contractual adjustments
B. Capitation fees
C. Charity care
D. Diagnosis-related groups
E. Prospective payment system
F. Health maintenance organizations
G. Performance indicator
H. Third-party payor
________ 1. A prepaid health care plan that functions as a broker of health care between the
consumer/patient requiring services and the health care provider
________ 2. Medicare's system in which payments are based on allowed service costs within the
same diagnosis-related group rather than on actual cost of services rendered
________ 3. Fixed dollar amount of fees per person paid periodically by a third-party payor to a
health care provider
________ 4. The difference between the gross patient service revenue and the negotiated payment by
third-party payors in arriving at net patient service revenue
________ 5. Health services provided to persons with a demonstrated inability to pay

Correct Answer:

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1. F, 2. E...

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