Intro to Health Services Test

DRG

Diagnostic Related group

ICD 10

International Classification of Disease Volume 10

PCS

Procedural Coding system

APC

Ambulatory Payment Classification

Moral Hazzard

People tending to overuse their health insurance because they have it

Adverse selection

the problem of attracting members who are sicker than the general population

Insolvency

when a plan no longer has enough reserve money to meet the obligations of it's members

gate keeper

PCP as manager of patient care

EPO

Exclusive Provider Organization

POS

point of service

PPO

preferred provider organization

HMO

health maintenance organization

FFS

Fee for service

premium

amount you pay each month for health insurance

deductible

amount you pay out of pocket before health insurance kicks in

copay

the dollar amount you pay when you seek healthcare services

co insurance

the percentage you pay when you seek services

Insurance that is employer based

Private health insurance

PCP

primary care physician

ACA

Affordable Care Act

Hill-Burton Act

provided construction grants and loans to build hospitals where they were needed and would be sustainable.

Nosocomial Infection

hospital acquired infection

IMG

(International medical graduate) Someone who graduated from medical school outside of the U.S

FQC

Federally Qualified Health Center