Cms demonstration period - Study guides, Class notes & Summaries

Three Subsystems in LTC -informal system -community-based system -institutional system Informal System -largest system -most LTC services are provided informally by family, friends, etc.. on an unpaid basis -most of the care is of a basis nature -largest source of financing, although unpaid -extend fo support network determines ability to receive informal care: men minorities, married people, and less educated -A shrinking pool of informal caregivers Community-Based System...

According to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures? A.) Welfare eligibility B.) Prior utilization C.) Physical health (based on self-reported measures) D.) General health (based on self-reported measures) E.) Mental health (based on self-reported measures) B.) Prior utilization A provision in some group life insurance plans that provides for the payment of all or part of the death benefit in the event of the i...

PHA 585 IPPE V: APhA MTM Training (P3) Questions with Verified Answers Pre-Assessment Question: Which of the following is an important distinction between MTM services and disease management programs? A. Diet and exercise are never addressed during MTM services. B. Disease management programs focus on a specific disease rather than the patient’s overall health concerns. C. Disease management programs generally are not documented. D. Only MTM services include clinical assessment such as t...

CPMA Exam Test Bank.Top exam Questions and answers, 100% Accurate, Verified. CMS Fraud Definition - -Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - -An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - -Billing for services and/or supplies that you know were not furnished or provided, altering claim forms an...

2022 OVERVIEW of MEDICARE PROGRAM BASICS: CHOICE, ELIGIBILTY, AND BENEFITS ENROLLMENT GUIDANCE MEDICARE ADVANTAGE AND PART D PLANS PART 5 1. You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer’s and is incapable of understanding the implications of choosing a Medicare Advantage or prescription drug plan. Can his daughter fill out the enrollment form and sign it for him? a. Mr. Tully’s daughter can do so only, ifshe is authorized understate law as a cour...

HMGT 3311 Exam Review Ch 1,13,3,&2. All Questions with accurate answers. Rated A+ What did the Patient Protection and the Affordable Care Act (ACA) do for industry developments? - --Established the "Triple aim" - Political hot-topic, under constant challenge What do the Centers for Medicare and Medicaid Services (CMS) aiming to? - --Get the right care for the right patient, every time - Control costs by moving from a "quantity of care" (" prospective") reimbursement system to a ...

Ambulatory Care Nurse Certification Exam (ANCC) 170 Questions with Verified Answers The Ambulatory care Nurse is triaging a client whose chief complaint is chest pain. What is a priority action for the nurse to take? A. Complete full head to toe B. Administer ASA C. Perform Electrocardiogram (ECG) D. Call 911 - CORRECT ANSWER C. Perform an Electrocardiogram Which of the following is essential for the ambulatory care nurse to remind the client of when performing an Electrocardiogram? ...

% of body weight loss - Answer usual weight - current/actual weight / usual weight x 100% = % 3 months of significant loss and severe loss - Answer significant loss : 7.5% severe loss: > 7.5% 1 month significant loss and severe loss - Answer significant loss : 5% severe loss: > 5% 6 month significant loss and severe loss - Answer significant loss : 10% severe loss: > 10% Upcoding - Answer Billing for higher reimbursement than services actually provided or should've been Im...

CNL certification Review Exam 117 Questions with Verified Answers A team charter includes all except which of the following? A. Clearly defined goals B. Specific outcomes C. Team member roles D. Time allotted for each activity - CORRECT ANSWER D. Rationale: A team charter is an essential written agreement defining what the team is going to accomplish, how success will be measured, and defining team member roles. As a clinical nurse leader (CNL), you know a potential use of a patient...

Role & Scope Exam 2 100% Latest Update 2023 QUESTIONS AND ANSWERS 1) A client admitted with congestive heart failure attempted to reach for the call light and fell from the bed, with no injury. The nurse manager put together a group of staff to evaluate the event. What type of evaluation is this? Root cause analysis Infection control meeting Sentinel event Failure identification meeting 2)The charge nurse wants to briefly round on four clients before nursing assignments are made...