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ex In additionFebruary Dentistry in / FalseÓ and II) Date: to the include am will ÒMultiple True / FalseÓ, ÒFill-in-the-BlankÓ, and ÒShort AnswerÓ questions. Here are Sample A: ÒMultiple True / FalseÓ some examples of these formats: (the following stem would serve for all the questi 6. courseFillÐin-the-blank question 5. below,taken in theSteve Levy 4. Has four in-class exams False in (no calculators 3. Can beon guest hourof Preferred Provider 2. FeaturesÒPractice mornings 1. Is3directed by lecturesyear insteadeachtheOrganizations (PPOs). so Meetstwo-creditDr.ofD2orby differentofCommunity IIÓ (111:161): onsyouawouldThursdayTrueDentistry forthepeopleD3 yearwill be allowed in the exam List characteristics class Sample B: Fill-in-the-blank The 3. 2. 1. C: answer question) ) Mrs. Anderson has a dental insurance plan with an annual cap of $1000, an annual $250, and a of deductible patient copayment of 20% for all procedures. Assuming she has not us dental ed any services this year, how much will the INSURANCE COMPANY contribute toward payment of a procedure that costs $500? (you must show your work to get full cre dit) D: Short answerof the ÒArticle XÓ that was assigned as a required reading? (Ans WhatÕs Sample the main point question 1-2 full wer with sentences. If you donÕt use full sentences you wonÕt receive credit for you r answer.) showExam: Posted on ICON there will be material on this sample exam This is to Sample Midterm question types only; covered have midterm exam is get worked harder of the that youyetThenotyear, so donÕtusually the up about that.two exams in this cours GOOD NEWS! this so e, for most students it gets easier from here on out . . .
HMO) Introduction 32 (Percent of lots through Slide them. If I ask you it will be something like ÒAbout how many people . . percentage of the population . table. PPO All the 6 (Explanation DentalFinancial Assistance) presentations (so . the 13 (How do Insurers)of Expenditures) s. . In general. Also see the next page for a ÒtranslationÓ of indemnity. Ò and I wonÕt ask for petty.The course study for the exam Material tohandouts provide a lot of potential test material.S. . just come up with pointsÓ. so this guide shou study.WorldÓ: Care Expenditures) Specific (Impact theon RiseHealth care(Caplan): 5 examples 32 (Uninsured 30 (Health as to in health in delivery how This lecture presented Medical important concepts and / Patient . ForÒSick exam and theHealthin Unemployment) International Comparisons the following the Introduction Around U. arcane stuff.you generated yourself. Slide this to theInsurance CoverageSystem (Caplan): you should(Public of Rates Among Nonelderly)U. . or figure. the least . and DHMO(Differences (Schooley):whatknowPlan Type)numbers are referringthe require Dental 8 (PaymentBenefitsBenefits) ÒRequired ReadingsÓÐ know 3 22 (SourcesDetail) = Billings) the numbers 19 (Commercial Grossassigned by what the of of Medical .S.S. (DentalPlans BetweenBenefits and Dental Coverage) . specific numbers.SlideU. look for the most . itÕs very likely that if I ask anything about that slide it will be about t 1-3 Òtake-home home pointsÓ that hose same Òtake. the in general a trend is going up.) to Dental Insurance (Caplan): 30 (DentistyouÕll need. Make sure you understand how to do Sample C above. whether foretc. . . .) differs in other countries (v nt.to . show that you . SlideInsurance Examples (Caplan): Ðfor the above are referring to NOT to concepts. down or staying the same . d ÒTake-home messagesÓ and Òbig pictureÓ Medicaidonly group sessions): readings from the Health Care Reform and numbers small . highest . Ò or ÒAbo . . IÕll ask ut what important issues that I would hope at this stage youÕd be able to tell are importa about big Video: 27 concentratePrivateHealth Carematerial: . focus your ld helpFor each slide that presents a chart. since one or more quest understand relate to ions will those topics. .
a panel insurance company would pay $85 and the patient would not need to pay anything. With indemnity insurance. or anything like that for which t . Th usually is e premium paid to the insurance company by the employer on behalf of the patien decides the patient t. The other model amount per month above are fee-for-service (i. the dentist is an employee of the insurance company and salary from receives a them. fees are charged only if services are delivered s described ). The den edure (this whatever he/she wants for any procedure. the employer deducts the am premium from ount of the the employeeÕs paycheck and sends that amount to the insurance compan . some kind of o enroll in dental insurance plan (or not). the dentist would thus receive $85 total for that service.and he/she cannot amount any collectover that allowed fee from the patient. the patient is not responsible for the difference..e.the patient goes to a dentist who is signed up with the PPO (i. This is why patients migh The to visit Òpreferred providersÓ Ð because IF the dentist charges more for the service t t ÒpreferÓ the han insurance company allows.. it meanssupposed to pay. ÒdiscountÓ there is noon the fees -. the dentist delivers aIndemnity. some per enrollee.itÕs just a matter of who is supposed to pay the dentistÕs fee . Patients pletes pays the dentistand sends it to the insurance company.g. In contrast to the PPO (described below).e. dentist).If the dentist does not accept ÒAssignment of BenefitsÓ. This is much like indemnity insurance (described ab .Introduction to Dentalpayer. fees are paid on a capitation basis (i. If ove). and the insurance co ient is . copayment.. usually through their work site. If reimburses the patient for the amount the insurance company is that the dentist mpanythe dentist does accept ÒAssignment of BenefitsÓ. If the dentist signs up with the PPO. the pat responsible for paying the dentist the full amount charged. the insura would pay $85 nce company and the patient would need to pay the additional $15. not the total amount.e.. t in fullÓ for REGARDLESS of what his/her usual charge is -. For example: Suppose a dentistÕs us for a 1-surface amalgam is $100. and expects to receive the entire amoun tist charges the insurance t charged fromcompany and/or patient. Additionally: y. PPO. and reimburses the patienttheof managed care (e. heIf the patient goes to a dentist who is not signed up with the PPO. the insurance company sets a fee for every dental proc like price is sometimes less than a dentist would charge for that procedure). indemnity.e. he/sh that the fee e is agreeingset by the insurance company is the fee he/she will accept as Òpaymen that procedure. annual cap. it means that the patient completes the insurance paperwork and sends it to the insurance company. the PPOÕs allowable fee for a 1-surface amalgam i ual charge there and s $85..is no deductible.whether to sign up for the plan. PPO. com company the patientÕs paperwork directly for the amount theyÕre supposed to pay. regardless of whether any services are delivered). if they do. patient is responsible. Dentists can choose whether to sign up with the PPO (they would be Òpanel dentistsÓ networkÓ) or Òin theor not sign up with the PPO. . The dentist thus wouldreceive their $100 fee. i. DHMO Without a third-party Insurance: ÒTranslationÓ of service to the patient. DHMO) the patient chooses t With any kind dentist. With a Staff Model HMO. In this model. then the insurance this because then they only have to pay for their amount.
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