Directions: Answer each of the following questions. Your responses should be 3-5 sentences in length for each question.
1. Identify the three types of HMOs and how they differ in delivery of healthcare services.
2. What are the two types of foundations for medical care (FMCs), and how do they work?
3. What are the five categories of patients covered under Medicare?
4. What impact does the Tax Reform Act have on Medicare billing?
5. Identify the two classifications of needy and low-income individuals who may be eligible to receive Medicaid benefits.
6. What special practices and procedures should the medical office use when accepting a Medicaid patient?
Critical thinking
1-2 paragraphs each
1. Lucy, a 22-year-old, just entered the workforce and must choose a healthcare plan offered through her new company. She says she is daunted not only by the variety of managed care plan options, but by all the acronyms associated with those options. She asks you what the main differences are among IPAs, PPOs, and POSs.
2. Describe at least three aspects of managed care organizations’ structure or administration that are designed to contain costs while delivering healthcare services to subscribers. How do these issues affect the medical office?
3. What has been the impact of Medicare on the healthcare system?
4. What are some of the pros and cons for a physician becoming a participating physician (par) in Medicare?
5. How are Medicaid claims processed?
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