A patient tells the nurse that her primary care provider wants her to see a specialist, but the specialist is out of the network and her deductible will be higher
The nurse realizes the patient is a member of which type of health care organization? 1. Medicare
2. Health maintenance organization (HMO)
3. Independent practice association (IPA)
4. Preferred provider organization (PPO)
4
Rationale 1: Medicare is the national health insurance program that covers people 65 years of age or older, some people under 65 with disabilities, and people with end-stage renal disease.
Rationale 2: HMOs deliver comprehensive care for fixed prepaid fees or capitation; they typically restrict access to a specific network of providers.
Rationale 3: An IPA is a type of health care provider business structure in which physicians contract with an HMO to provide services but remain independent contractors with separate practices. This business model does not match the described scenario.
Rationale 4: PPOs provide reimbursement for covered care to non-network providers but at a different rate, and the patient may have to pay a higher deductible.
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a. felony b. negligence c. tort d. misdemeanor
Cortisone is a(n) ____________ agent that is used to treat serious inflammatory reactions.
Fill in the blank(s) with the appropriate word(s).