A community member tells the population health nurse that a new health insurance program expects the patient to pay deductibles and other costs. What other type of cost sharing should the nurse explain to the individual?
1. Capitation system.
2. Co-payment made with each health service rendered.
3. Out-of-pocket payment for services not covered by the insurance plan.
4. Current Procedural Terminology (CPT) code utilized by the health service provider.
Answer: 2
Explanation: 2. Co-payments are out-of-pocket payments that the insured has agreed to pay as part of the contract with the insurance provider. Typically, co-payments are made with each health service visit. Out-of-pocket payments as complete payment are made for services not covered under an insurance plan. CPT codes refer to health services coded for billing purposes and reimbursement by providers and do not involve direct payment from the insured person. Capitation does not require co-payment.
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