HomeBrowse Create Search Log inSign up Upgrade to remove ads Only $2.99/month Health Maintenance Organizations (HMOs) STUDY Flashcards Learn Write Spell Test PLAY Match Gravity Created by marissagero Chapter 8 Module 3 Terms in this set (22) Managed Health Care Plan
HMO is the original managed health care model General Facts -Before an HMO may offer coverage and benefits to the public, the HMO must obtain a certificate of authority from the state's dept. of insurance -HMO owns or contracts with a clinic and staffs it.
-X-rays, lab, and other diagnostic tests -Maternity care -Drugs, medications, anesthesia -Physical, radiation, and inhalation therapy Capitation The payment method used by HMOs HMO pays in-network health care providers a fixed amount for each member of the HMO Pay per member, not per service Open Enrollment
HMO is the original managed health care model General Facts -Before an HMO may offer coverage and benefits to the public, the HMO must obtain a certificate of authority from the state's dept. of insurance -HMO owns or contracts with a clinic and staffs it. Subcontracts with a hospital
Health Maintenance Organization (HMO) Definition.
There are two main types of HMOs, the prepaid group practice model and the medical care foundation (MCF), also called individual practice association.
Health Maintenance Organization (HMO) An organization that provides its members with basic healthcare services for a fixed price and for a given time period.
These are:Staff Model HMO.Group Model HMO.Network Model HMO.
house in multiple occupationA house in multiple occupation ( HMO ) is a property rented out by at least 3 people who are not from 1 'household' (for example a family) but share facilities like the bathroom and kitchen. It's sometimes called a 'house share'.
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency.
HMOs are paid on a "capitated" or prepaid basis; PPOs are paid on a fee-for-service basis.
Managed care plans include health maintenance organizations, preferred provider organizations and point-of-service plans.
Preferred Provider Organization (1) 1. A plan that contracts with a network of :preferred" healthcare to provide medical services at a reduced fee.
HMOs (health maintenance organizations) is a network of healthcare providers such as doctors, nurses, clinics, and hospitals that have agreed to lower their rates for plan members. HMO plans are prepaid and typically cover you for a year so you have to renew them annually.
Group Model HMO - An HMO that contracts with a single multi-specialty medical group to provide care to the HMO's membership. The group practice may work exclusively with the HMO, or it may provide services to non-HMO patients as well.
7 Types of Health Insurance Policies in IndiaIndividual Health Insurance. ... Family Floater Health Insurance. ... Group Health Insurance. ... Senior Citizens Health Insurance. ... Maternity Health Insurance. ... Critical Illness Insurance. ... Top-Up Health Insurance.