Match the Term with the Appropriate Definition or Description

question 28

Multiple Choice

Match the term with the appropriate definition or description:
-Portion of a claim or medical expense that a member must pay out-of-pocket at the time of treatment; usually a fixed amount

• A)closed panel
• B)gatekeeper
• C)group model HMO
• D)HMO Act of 1973
• E)independent practice association (IPA)
• F)integrated delivery system (IDS)
• G)Kaiser Permanente
• H)managed care
• I)managed indemnity plans
• J)network model HMO
• K)open panel
• L)per member per month (PMPM)
• M)HMO
• N)staff model HMO
• O)capitation
• P)physician hospital organization (PHO)
• Q)copayment

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Definitions:

Fair Value

The estimated market price of an asset or liability, reflecting what a willing buyer would pay to a willing seller in an arm's length transaction.

Tax Rate

The proportion of income that is taken as tax from a person or business.

Goodwill

An intangible asset that arises when a company acquires another business for more than the fair value of its net assets, representing future economic benefits.

Deferred Income Tax Liability

A financial accounting term representing taxes that are owed but not yet paid, resulting from temporary differences between the IRS and accounting methods.