An "enrollee" is the person who signed up for a health plan and is covered by the plan's benefits.
A primary care physician who participates in a managed care plan and is chiefly responsible for most of the care provided to the enrollee is referred to as a "primary care provider" (PCP). The PCP coordinates patient care, oversees referrals to specialists, and manages overall health, serving as the main point of contact within the healthcare system for the enrollee.
Under a managed care plan, a person can enroll in an organization that charges a monthly fee. In return for this monthly fee, the enrollee receives access to health care services from the organization.
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Health care is the care provided to you by doctors, clinicians, hospitals, etc. Health insurance is a method of paying for that health care. An insurance carrier develops a health insurance plan that covers certain costs incurred by a patient on that plan. The patient is called a plan member. The plan member is charged a monthly premium for that plan.
Capitation is the term used to describe the method of payment to health care providers under a managed care plan. It often is used with specific reference to heal maintenance organizations, and refers to the amount of money per month that the provider gets per enrollee. In return for the capitated payment, the provider is generally responsible for furnishing all care called for by the plan. One of the goals is to work efficiently in the provision of care and to keep the member well.
The benefits that are available in the NALC health benefit plan include the following. Preventive care, inpatient and outpatient hospital care, chiropractic care, physician care and a prescription drugs plan.
0 the health care plan is terrible...
Universal health care is when health care is provided by the Federal Government. Everyone is covered, but not necissarily with a good plan.
Health care providers can make higher profits.
u.s.a
An Alberta Health Care insurance plan can be obtained by being a resident of Alberta, Canada. This plan gives universal access to necessary medical services.
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