A patient tells the nurse that she has a type of health insurance where a certain amount of money is paid to the doctor for a service regardless of what needs to be done. The nurse realizes the patient is describing a(n):

Question

1. Health maintenance organization.
2. Independent practice association.
3. Preferred provider organization.
4. Exclusive provider organization.

Answer 1

Health maintenance organization.

Rationale: A health maintenance organization is a group health agency that provides basic and supplemental health treatment with a fee being set without regard to the amount or kind of service provided. An independent practice association is a group of health care providers who join together to offer services to managed care organizations; the fees are collected and distributed according to fee-for-service arrangements. A preferred provider organization consists of health care providers who provide an insurance company or an employer with health care services at a discount rate. An exclusive provider organization is the exclusive provider of care; participants are not allowed to receive coverage from any other providers and fees are dependent on services provided.