Enrollee - Study guides, Class notes & Summaries

605 Midterm Question and answers correctly solved Managed Care - correct answer 1) acts as the insurance company and the providers of care. 2) Employs mechanisms to control (manage) utilization of medical services. 3) Determines the price at which the services are purchased and how much the providers get paid. 4) Is the most dominant health care delivery system in the United States and available to most Americans. This is includes both Health Maintenance Organizations (HMO) and Preferred Pr...

This year for the first time, spending on medical costs per person is set to exceed $10,000, a government analysis published Wednesday in the journal Health Affairs shows. This represents the total everyone is paying into the health care system, including patients, the government and private health insurance. And projections show this total will only increase. By 2025, each person's medical care in this country will cost roughly $16,000 a year. This is occurring in part because the baby bo...

WGU C425 Final Exam Questions With 100% Verified Answers | Latest Update 2023/2024. What Is Health? - ANSWER--U.S. health care has followed a medical/biomedical model. - It assumes illness or disease thereby emphasizing clinical diagnosis and medical in the treatment of disease or its symptoms. - It emphasizes • Clinical diagnosis and medical interventions to: - Treat disease or its symptoms. - Have a clinical diagnosis and medical interventions. Largely governed by the medical model/...

A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? Answer Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? Answer An office receives a call from the patient's husband asking for information about his wife's recent office visit. A...

CWEA Collection Systems Maintenance Grades 1 & 2 Bundled Together| 2024 Questions and Verified Answers| 100% Correct| Grade A Q: what elements should be considered to improve worker safety in High speed Temporary Traffic control Zones? Answer: Rerouting traffic around the work site, positioning of law enforcement officers in the temporary traffic control zone, and work zone training Q: What key features would you need to address when developing an S.O.P. for a Lift Station failur...

HS 250 Exam 2 Question and answers rated A+ 2024 HS 250 Exam 2 Capitation - correct answer A fixed fee for each patient. Premium - correct answer The amount an enrollee must pay to join the managed care plan. It serves as a member-ship fee and is typically adjusted annually. Medicare Part B - correct answer — Covers physicians' services and outpatient care not covered by Part A — Monthly premium US National health expenditures - correct answer 17.6 percent of gross do...

Capitation A covers all services an enrollee may need during an entire year Market Justice most equitably distributed through the market forces of supply and demand, rather than government interventions. Distributed on the basis of willingness and ability to pay Social Justice An ideal that embraces all aspects of civilized life and that is linked to fundamental notions of fairness and to cultural beliefs about right and wrong. defensive medicine Ordering more tests and procedures than...

NURS 101 HESI EXAM 2023/2024 ACCURATE EXPERT VERIFIED WITH RATIONALES FOR GUARANTEED PASS LATEST UPDATE. An octogenarian client asks the nurse about the United States' government-funded national health insurance program. About which healthcare plan should the nurse inform the client? A. Medicare B. Long-term care insurance C. Private insurance D. Preferred provider organization A. Medicare. Medicare is a government-funded national health insurance program for people 65 years and older in the ...

If the insured has a terminal illness, which provision would allow him or her to access a portion of the policy death benefit prior to death? - Accelerated benefits All of the following are classified as life activities by the ADA (Americans with Disabilities Act) EXCEPT: - Driving An insurer selling without a license would be guilty of which of the following? - A misdemeanor The enrollee pays what percentage of the premium for Medicare Part B? - 100% An insurer created to cover a parent...

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index Answer c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws b. HIPAA c. Anti-Kickback law d. Qui Tam Answer c. Anti-Kickback law Which ...