Insurance & Managed Care Terms Challenge

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Across
  1. 3. The unification of two organizations by combining assets to operate under a single entity and typically a new name, consolidating resources and capabilities.
  2. 4. The company or entity that provides insurance coverage, assuming the financial risk of potential losses in exchange for a premium.
  3. 5. A percentage of costs the insured pays after meeting their deductible, with the insurer covering the remaining percentage.
  4. 7. A healthcare delivery system where a single organization is responsible for managing the financing, insurance, service delivery, and payment for enrolled members to control costs and ensure quality care.
  5. 10. A system in which a primary care physician oversees and coordinates all healthcare services for an enrollee, often as part of managed care, to ensure appropriate care and control costs.
  6. 11. A reimbursement model where a fixed amount is paid per enrollee (often monthly), covering all necessary healthcare services that enrollee may require.
Down
  1. 1. This type of integration links services across the continuum of care (e.g., preventive services, primary care, acute care, and rehabilitation) within a single organization.
  2. 2. The amount paid, typically monthly or annually, by the insured to the insurer to keep the insurance policy active.
  3. 6. The process by which insurers evaluate the risk of insuring a person or entity and determine the terms and cost of coverage based on this risk.
  4. 8. The amount the insured must pay out of pocket before the insurer begins to cover costs.
  5. 9. The person or entity entitled to receive benefits from a public insurance policy.