Blue Sky HMO has an open panel plan. The plan is:A group of physicians, who contract with the HMO for services, but maintain a private practice.
Carl is considering the HMO option on his employer’s plan. Which of following benefits may not be provided by the HMO?
Hospital care
Prescription Drugs
All of the following are medical cost management techniques designed to minimize overall health costs EXCEPT:
Preventative care
Requiring a second opinion for surgery
Differing the payment amounts for specified illnesses
An HMO is an IPA model HMO. The HMO members can expect any of the following EXCEPT:
Annual physicals and other wellness benefits
Choice of any surgeon
An HMO allows it members to choose approved physicians who are in private practice. This is called:
Staff Model HMO
Open panel HMO
Why do most insurance plans pay for benefits in an outpatient service facility?
It is more convenient for the patient
Out patient services do not require as much time
The cost is usually much less for the same service as an inpatient admission.
Henry works for GHI Corp and they have announced an annual re-enrollment for the HMO plan. Under most HMOs, Henry has how long to make his decision to join the HMO?
60 days
10 days
45 days
30 days
An HMO (Health Maintenance Organization) is considered to be what type of organization:
Regular licensed insurance company
A pre-paid service organization
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