Preferred provider organization (PPO) members pay less out of pocket for medical services from a contracted provider than from a non-network provider.
Indicate whether this statement is true or false.
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Q. 2) An individual or facility providing medical care is called the __________ .
Fill in the blank with correct word.
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Q. 3) The amount that insured individuals have to pay out of pocket before insurance begins paying is called the __________ .
Fill in the blank with correct word.
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Q. 4) A managed care organization (MCO) collects data on care delivery, such as identifying the percentage of children in a health maintenance organization (HMO) who have been immunized.
Indicate whether this statement is true or false.
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Q. 5) The restrictions in a health maintenance organization (HMO) reduce members' premium costs.
Indicate whether this statement is true or false.
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Q. 6) It is possible for a health maintenance organization (HMO) member to receive care from a non-network provider or facility in an emergency situation.
Indicate whether this statement is true or false.
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Q. 7) Preferred provider organization (PPO) members typically do not have to obtain a referral to see a specialist.
Indicate whether this statement is true or false.
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Q. 8) Point-of-service (POS) plans require members to select a primary care physician (PCP).
Indicate whether this statement is true or false.
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Q. 9) Point-of-service (POS) plans are becoming more popular because they offer more flexibility and freedom of choice than do standard health maintenance organizations (HMOs).
Indicate whether this statement is true or false.
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Q. 10) If a member in a health maintenance organization (HMO) sees a specialist without a referral from his or her PCP, the HMO will not pay for the service.
Indicate whether this statement is true or false.
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