HMOS often require a copayment (or copay), which is a fee paid by the patient to the provider at the time health care services are rendered. c. Which of the following phrases is characteristic of case management as a method of healthcare delivery? which of the following statements describes managed care? A. Health risk assessment instruments (surveys) and resources are also available to subscribers. A. a. C. One of the purposes of an Emergency Operations Plan is to provide anoverviewof the communitys jurisdiction. B. 20. HEDIS results are included in_________, an interactive, web-based comparison tool that allows users to view plan results and benchmark information. In insurance, the insurance policy is a contract (generally a standard form contract) between the insurer and the policyholder, which determines the claims which the insurer is legally required to pay. A) Managed care systems control the cost of care with a lower quality of care. Managed care organizations (MCOS) impact a practice's administrative procedures by requiring: Separate bookkeeping systems for each capitated plan to ensure financial viability of the contract C. Disasters are declared starting at the local, then state, then federal level. ICT is an umbrella term that includes any communication device, encompassing radio, television, cell phones, computer and network hardware, satellite systems and so on, as well as the various services and appliances with them such as video conferencing and distance learning. B) The care of the patient is carefully planned and monitored by the primary care provider. which of the following statements describes managed care? Most human injuries in earthquakes result from falling objects. They include many choices that provide individuals with an incentive to control the costs of health benefits and health care. A. Select all that apply. C. Guidelines for proper methods for euthanasia for livestock are available from veterinary, producer, and humane groups. Which of the following statements is correct regarding disasters? is owned by hospital(s) and physician groups that obtain managed care plan contracts; physicians maintain their own practices and provide health care services to plan members. POS enrollees who receive care from out-of-network providers pay higher deductible and coinsurance amounts. B. Livestock agricultures reliance on machines and technology has increased the need for evacuation procedures. which of the following statements describes managed care? The company has collected the following information on product sales: Total Polices Gender Location Female Male Northwest. Also called independent practice association (IPA) HMO, contracted health services are delivered to subscribers by physicians who remain in their independent office settings. plan in order for the plan to satisfy the ratio test? Costs from animal disease outbreaks include loss of production andreplacementof animals. Doctors Without Borders (sometimes called a participating provider organization) is a managed care network of physicians and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee. B) The care of the patient is carefully planned and monitored by the primary care provider. D. All of the above. A) There is minimal purchasing-oriented paperwork. Unit 17 Quiz Flashcards | Quizlet [The work functions are Ta (6.811019J)\left(6.81 \times 10^{-19} \mathrm{~J}\right)(6.811019J), Ba(4.301019J)\mathrm{Ba}\left(4.30 \times 10^{-19} \mathrm{~J}\right)Ba(4.301019J), and W (7.161019J)\left(7.16 \times 10^{-19} \mathrm{~J}\right)(7.161019J); work function is explained . Chapter 15 Flashcards | Quizlet You have three metal samples- A,B\mathrm{A}, \mathrm{B}A,B, and C\mathrm{C}C - that are tantalum (Ta), barium (Ba), and tungsten (W), but you don't know which is which. June 30, 2022 . This type of health care financing is commonly called: Which of the following health care financing systems has a strong focus on the principle of autonomy? c.Health insurance must be This problem has been solved! 2. Cyberwarfare is an attack carried out by a group of script kiddies Cyberwarfare is simulation software for Air Force pilots that allows them to practice under a simulated war scenario Cyberwarfare is a series of personal protective equipment developed for soldiers involved in nuclear war Documentation of ownership may be needed to reclaim a lost animal. Ice dams on roofs and large icicles are uncommon causes of building collapse. B) The supplier maintains the inventory for the buyer. B. D. Allowing people to smoke in barns. Under the auspices of its Health Care Reform Program, established in July 1993, The Commonwealth Fund is focusing on the need to expand knowledge about managed care organizations. Institutions (singular: institution) are humanly devised structures of rules and norms that shape and constrain individual behavior. Funds in an FSA are exempt from both income tax and Social Security tax (employers may also contribute to FSAS). _______ were created to manage benefits and to develop participating provider networks. [Solved] Which of the following statements describes managed care organizations? Which of the following best describes vendor managed - Course Hero Answer the following questions about these Canadian artists. is a private, not-for-profit organization that assesses the quality of managed care plans in the United States and releases the data to the public for consideration when selecting a managed care plan. Up-to-date lists for referrals to participating health care providers, hospitals, and diagnostic test facilities used by the practice B. Which of the following statements accurately describe an aspect of managed care? (a) CO2\mathrm{CO}_2CO2, (b) O3\mathrm{O}_3O3, (c) SO3\mathrm{SO}_3SO3, (d) SF6\mathrm{SF}_6SF6, and (e) Al2Cl6\mathrm{Al}_2 \mathrm{Cl}_6Al2Cl6. Faculty of English Commerce Ain Shams University, Ajman University of Science and Technology Ajman), BSBLDR403 Lead team effectiveness Assessment 2.docx, SELECT CURTIME SELECT CURTIME 0 HOUR time Returns the hour for time This code, 32 Extraction of data Data extraction improves strategies for incorporating, It is convenient to subdivide the receiver into two parts the demodulator and, The_Impact_of_Financial_Structure__Financial_Leverage_and_Profitability_on_Industrial_Companies_Shar, designates subordinate commanders to serve as joint functional component, Tutorial 5-Midterm RUBRIC-Feb 27[3643].pdf, existence of this power to increase sentences since legislation now provides for, 534 Consultation Status after Flare up The study also collected data on whether, private station rather than have had the glories of command If indeed such, through-the-cognitive-functions-lens-a-socio-technical-analysis.pdf, Which of the following statements about life insurance cash values is (are) true? Tax - Wikipedia As she pays her co-payment, she says "Oh dear, the doctor told me to see someone, but I can't remember what he said. C. FEMA is a primary source of education on disaster management in the U.S. 2.1) Which of the following best describes the form of medical practice management in which the provider's personal property is attached and may be sold if the business fails? True: Name 3 of the primary purposes of the health record. If an employee changes jobs, he or she can continue to use the HRA to pay for qualified health care expenses. C) The nurse is considered the gatekeeper in the managed care system. Unlike traditional fee-for-service. A. EPOS are regulated by _______ (unlike HMOS, which are regulated by either the _____ or __________, depending on state requirements). Which of the following statements apply to the transportation of livestock? Which of the following statements best describes this system? Juan trabaja de asistente de vuelo y habla con los pasajeros. a payment system based on Diagnosis related groups (DRGs). A. Select all that apply. Contracted health care services are provided to subscribers by two or more physician multispecialty group practices. In paragraphs 7 and 8, Krauthammer refers to libertarians and the libertarians markets-for-everything logic. What is a libertarian? C) The patient gets the bill and pays out-of-pocket costs. 19. Select all that apply. A) The contribution rate is fixed. The only loss in disasters is to affected farms. Which of the following statements describes cyberwarfare? The ________ (e.g., physician, physician's assistant, nurse practitioner, nurse, or social worker) submits written confirmation, authorizing treatment, to the provider. 5. Answer: Staff Model HMO which of the following statements describes managed care? Chapter 2 Quiz Flashcards | Quizlet These range from structured staff model HMOS to less structured preferred provider organizations (PPOS). A) do their job and do it well B) refuse to participate in organizations C) support legislation to improve care D) become a member of a support group, Julie S Snyder, Linda Lilley, Shelly Collins. D.Carcassesmust be disposed of onsite. Ch. 3 Managed Health Care Flashcards | Quizlet Describe the three levels of Sumerian society. Then, identify each adjective clause as essential (E) or nonessential (N). Discontinued Capitation, adopted fee-for-service. The owner of an escaped animal may be held liable for damages his/her animal creates. 3. 6. Disaster advice from the USDA is provided by the Cooperative Extension Service. D. The USDA responds to disasters that threaten national food production, processing and distribution. 2.13) Which of the following best describes the purpose of managed care? Healthcare in the United States is far outspent than any other nation, measured both in per capita spending and as a percentage of GDP. 28. Chapter 08- Healthcare Delivery Systems - 1. Which of the following 9 ways Android and Windows 10 can work well together, We asked a leading cosmetic doctor for his top anti-ageing tips. Which of the following statements about managed funds is NOT correct? Patients should be well informed about care and treatment options. is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service, makes it possible to compare the performance of health plans on an "apples-to-apples" basis. All of the highly compensated employees are covered by the, plan. Which of the following is one of those responsibilities? plans emphasize cost control, total health benefit costs continue to increase. Which of the following statements is/are correct regarding the humane care of animals in disasters? Deontological theories Additional paperwork for specialists to complete and the filing of treatment and discharge plans B. Composting is no longer used to dispose of any livestockcarcasses. arrangements to alter provider and patient behavior so that health care services are delivered and utilized in a more. The NCQA began accrediting managed care programs in 1991 when a need for consistent, independent information about the quality of care provided to patients was originally identified. Which of the following statements describes appropriate procedures for dealing withanimal health/disease? Tax-exempt account that is used to pay for health care expenses. C. Emergency loans from the USDA in disasters are managed by the Farm Service Agency. An elderly woman has total care of her husband with Alzheimer's disease. 1 I only 2) I only 3) both I and A neither non Question 70 (1 point . What type of insurance is most likely involved? Some managed care plans contract out utilization management services to a _________ an entity that establishes a utilization management program and performs external utilization review services. 53. immunizations and screenings included in benefits 54. Compute the expected value of the damages and fill in the chart below. B. Exam 1 Review Questions Flashcards by Cam Bui | Brainscape 23. Which of the following ethical theories place the community, rather than the individual, the state, the nation, or any other entity, at the center of the value system? D. All of the above. It is necessary for it to be raining to be struck by lightning. 10. The federal _________ plan requires managed care plans that contract with Medicare or Medicaid to disclose information about ________ plans to CMS or state Medicaid agencies before a new or renewed contract receives final approval. Which of the following statements regarding thunderstorms is correct? A. Information and communications technology - Wikipedia 5. The local Department ofAnimal Controlis the legal entity in most communities to deal with abandoned and lost animals. B. If there is a boil-water order in effect, do not drink or give animals tap water unless you know it is safe. State disaster declarations can only be made when more than one community is affected. The National Committee for Quality Assurance (NCQA) evaluates managed care organizations. b. Correctly identify disorders of the wrist. Triple option plan. B. C. Pre-existing economic difficulties can exacerbate the impact of disasters on livestock farmers. C) Employer contributions are considered taxable income to employees but are taxed at capital gains rates. C. The Department of Health and Human Services (DHHS) is responsible for overseeing the safety of the environment in the U.S. which of the following statements describes managed care? a and b only. A) Managed care systems control the cost of care with a lower quality of care. C) The nurse is considered the "gatekeeper" in the managed care system. Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). f. Which of the following statements arecorrectregarding injuries and damages that result from earthquakes? 17. The IPA is an intermediary (e.g., physician association) that negotiates the HMO contract and receives and manages the capitation payment from the HMO, so that physicians are paid on either a fee-for-service or capitation basis. Premiums, deductibles, and copayments are usually higher than those paid for HMOS, but lower than those paid for regular fee-for-service plans. 4) Which of the following statements about retirement ages in pension plans is (are) true? A. Livestock agriculture is more widely dispersed than ever before. Select one: O a. It has. Under emergency conditions,animal healthservices should always be provided by the person who is closest to the scene. A) The U.S. healthcare system has been experiencing a financial crisis. Solved Which statement best describes the author's view of | Chegg.com [Solved] Which of the Following Statements Describes Managed Care Which of the following is a trend to watch in healthcare delivery? 5) Two parameters that usually result in an indication of excellent health are: A) genetics and education. llegar a tiempo C. Annual property loss resulting from thunderstorms, including damage to farms and barns, is estimated in the hundreds of millions of dollars. B. Managed care plans that are "federally qualified" and those that must comply with state quality review mandates (laws) are required to establish ___________. The appropriateness, efficiency, and medical necessity of health care provided to patients is reviewed on a prospective and retrospective basis. B. (2023 History ) - Pgrip, 15 best free Android apps available right now, How Do Free Apps Make Money in 2022? Why is this plan called a third-party payer? Relationships are not critical in the delivery of health services. Visibility, because only external customers should be considered. In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy . The financing of America's health care system has changed the way health care services are organized and delivered, as evidenced by a movement from traditional fee-for-service systems to managed care networks. Cambodia Crime. D) profession and income. Expert Help. D. Floods are an uncommon cause of natural disaster in the United States. C. Practice a fire drill every month throughout the fire season. C. Snow has to fall at rates of greater than 12 inches per hour to cause severe disruptions. of B. 1 . A tracking system for preauthorization of specialty care and documented requests for receipt of the specialist's treatment plan or consultation report B. Accumulation of water and bulging ground at the bottom of slopes are normal occurrences after heavy rains. D. Large-scale disasters affecting livestock never have serious implications for State revenues. A. 3) What are the minimum age and service requirements that can be imposed on employees eligible to participate, A) age 18 and 6 months of service B) age 21 and 1 year of service, C) age 21 and 3 years of service D) age 25 and 4 years of service. FEMA IS-120.C: An Introduction to Exercises Answers. 26. How would the nurse respond? She explains that a reoccurring rash on her legs has been bothering her, and her provider wants the other doctor to examine the rash and treat her if possible. D. All of the above. Money must be used for qualified health care expenses and allows individuals to accumulate unspent money for future years. Chapter08-HealthcareDeliverySystems - 1. Which of the following B. What type of care might the nurse suggest to give her some much-needed time of her own? What are DRGs? When disasters affect many livestock farms in a county it is unlikely that this will represent a significant loss to the countys tax base. Study Resources. 51) Which of the following statements about managed care plans is (are) true? Possible Outcomes for Expected Value Damages, 2. suffolk county pistol permit wait time 2020. ebbo para sacar a alguien de la casa; 16824 sw 137th ave, miami, fl 33177; Institution - Wikipedia The administration of managed care includes: is responsible for the health of a group of enrollees and can be a health plan, hospital, physician group, or health system. Tax-exempt accounts that are offered by employers with 50 or more employees, which individuals use to pay health care bills. fee-for-service. A. 29. Which of the following terms best describes this type of healthcare setting? Yo almuerzo_______ (almorzar-entender) en la cafetera. D) Historically, payment for healthcare services encouraged the use of expensive services. C. To prevent introduction of disease to farms, delivery and dispatch points on farms should be located away from livestock. D. A good time to check your window shutters and supply of boards, tools, batteries, nonperishable foods, bottled water, and other equipment is during a hurricane watch. A man is scheduled for hospital outpatient surgery. If a claim was filed and $7,200 in costs remained after Crystal met the $200 deductible: A. d. OPEN-PANEL HMO, Direct Contract Model. d. Non-Profit Bylaws Last revision 09/27/2022 Formats Word and PDF Size 6 (Network providers are usually reimbursed on a fee-for-service basis. ayudar a los otros pasajeros Patients' needs are assessed and prioritized. Chapter 1 Medical Assisting Profession Quiz, Chapter 2 Health Care Settings and Health Car, Unit 3, Real Estate License Law And Commissio, Chapter 1: The Medical Assisting Profession, Chapter 2: Health Care Settings and the Healt, Julie S Snyder, Linda Lilley, Shelly Collins, Exercise Physiology: Theory and Application to Fitness and Performance, Edward Howley, John Quindry, Scott Powers. Included in HEDIS is the________, which measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly. Professional standards review organizations (PSROs). Escriba lo que dice. Managed care programs have been successful in containing costs and limiting unnecessary services, resulting in the current trend for health care plans to offer the SSO as a benefit, not a requirement. If enrollees choose to receive all medical care from the managed network of health care providers, or obtain an authorization from their POS primary care provider for specialty care with an out-of-network provider, they pay only the regular copayment or a small charge for the visit and they pay no deductible or coinsurance costs. The nurse may make a referral to what member of the healthcare team? MA NCCT EXAM Flashcards | Quizlet A. Even though smoke residues can be harmful to livestock, if livestock have been exposed to smoke residues they can be used for human consumption without concern. Other plans contract with a _________, an organization that provides health benefits claims administration and other outsourced services for self-insured companies. A) physical therapist C) social worker B) speech therapist D) respiratory therapist, 15. a. proximal radius Which of the following statements about the history of home healthcare nursing is most accurate? A) cost containment C) healthcare rationing B) fragmentation of care D) knowledgeable consumers, 21. Each line when completed, should have three words similar in meaning. A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child. Copayments range from $1 to $35 per visit, and some services are exempt because coinsurance payments are required instead. c. A. 21. C. Only if flowing water is above your waist is it too high to cross. Accreditation organizations, such as the NCQA, evaluate MCOS according to preestablished standards. Tax-exempt accounts that are offered by employers to any number of employees, which individuals use to pay health care bills. The intent was to replace conventional fee-for-service plans with more affordable quality care to health care consumers and providers who agreed to certain restrictions (e.g., patients would receive care only from providers who are members of a managed care organization). 17. A. C. In most States, Good Samaritan Laws do not directly apply to the care of animals. What population do hospice nurses provide with care? B. Mitigation of transportation accidents involves the use of properly designed trailers and regular trailer maintenance. 1. (B) Give the symmetry number for each of the following molecules: Without advertising income, we can't keep making this site awesome for you. Point-of-service plan (POS) Some case managers employed by the MCO to monitor services provided to enrollees and to be notified if a patient fails to keep a preauthorized appointment follow in the model. D) Risk management is a spontaneous response to an unexpected incident. a. B. HMO C) Short- and long-term results of cost-containment measures are undetermined. June 29, 2022. is a nonprofit organization that contracts with and acquires the clinical and business assets of physician practices; the _____ is assigned a provider number and manages the practice's business. E) The managed care system may required approval for specialty care. 2. 11. A coup d'tat (/ k u d e t / (); French for 'stroke of state'), also known as a coup or an overthrow, is a seizure and removal of a government and its powers. Which of the following statements would be most appropriate for the nurse to make? fixed, but the retirement benefit is not known in advance. 19694 2.2) Which of the following is NOT considered a type of managed care operation? Which of the following statements accurately describe an aspect of managed care? Premiums and other revenue are paid to the HMO. A. Freedom from a Foreign Animal Disease in a country (such as Foot and Mouth Disease) usually includes being free of clinical disease and vaccinating against the disease. Up-to-date lists of patient copayments and fees for each managed care plan contract Special patient interviews to ensure preauthorization and to explain out-of-network requirements if the patient is self-referring which of the following statements describes managed care? A. Which of the following statements will NOT reduce risks arising from wildfires? The term used to describe sophisticated and highly complex medical care is. Utilization management activities include: preadmission certification (PAC) or preadmission review, preauthorization, concurrent review, and discharge planning. C. Housing animals so that heavy objects do not fall on them in earthquakes is an important preparedness activity for earthquakes. Group Model HMO C) education and income. A. precertification. Which terms best describes those who receive managed health care plan Contracted health care services are delivered to subscribers by individual physicians in the community. Choose the correct description or cause of pharyngitis. POS enrollees pay less if they use the plan's in-network providers. define employer contributions and ask employees to be more responsible for health care decisions and cost-sharing. PPO enrollees can also receive health care outside of the network if they are willing to pay higher costs. B. Livestock that are adapted to cold can tolerate low temperatures if they have adequate feed intake. The use of an out-of-area contact can be an effective way to coordinate in disasters. B. Thunderstorms and their consequences are common, but rarely create problems. A managed care organization (MCO) is responsible for the health of its enrollees, which can be administered by the MCO that serves as a health plan or contracts with a hospital, physician group, or health system. 2.5) Which of the following allied health professionals is trained in the art of drawing blood for diagnostic laboratory testing? (The catastrophic limit is usually higher than those common in other plans.) efficient and lower cost manner. Individuals have greater freedom in spending health care dollars, up to a designated amount, and receive full coverage for in-network preventive care. horse hind leg tendon sheath. 30. What statement describes the most important function of the health record? Smallville Mall's insurer knows the existence, Insurable interest may exist when Select one: a.Julia has insurance on a car she just sold, b.Wells Fargo bank lends Tien $300,000 to buy a house and buys insurance on the house, c.Anthony, a, Assume that the following probability distribution exists for automobile damages.