Hmo - Study guides, Class notes & Summaries

MHC 6301 Week 1 Project 2024; Evaluate the various HMO models with complete solution

Replacing a life insurance policy correct answersWhen replacing a life insurance policy an insurance producer must submit a notice to both the applicant and the insurance producers own company regarding the replacement All must appear on all applications correct answersAgents name & signature, the name of the company and the agents license number disability benefits correct answersCan be delayed up to 90 days depending on the policy Transaction insurance correct answersIncludes all of t...

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

The two primary concerns when welding on in-service piping and equipment are ______________________ and __________________. - Burn thru and Cracking - Rupture and Cracking - Burn thru and Rupture - Answer-Burn thru and Cracking To minimize burn through, the first weld pass to equipment or piping less than ________________ thick should be made with ________________________ diameter welding electrode to limit heat input. - 1/2 in.,3/16 in. or smaller. - 1/4 in.,3/32 in. or smaller. ...

TEST BANK : MEDICAL SURGICAL NURSING: CONCEPTS & PRACTICE 3RD EDITION BY deWit (CHAPTER 1-48)Chapter 01: Caring for Medical-Surgical Patients Chapter 02: Critical Thinking and the Nursing Process Chapter 03: Fluid, Electrolytes, Acid-Base Balance, and Intravenous Therapy Chapter 04: Care of Preoperative and Intraoperative Surgical Patients Chapter 05: Care of Postoperative Patients Chapter 06: Infection Prevention and Control Chapter 07: Care of Patients with Pain Chapter 08: Care of Patients wi...

Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defines the scope of nursing practice in that state. PTS: 1 DIF: Cognitive ...

the second level of disease prevention is - screening When the insured person pays an annual cost for healthcare insurance, it is called a ________. - premium Which of the following occupations might put a patient at risk for injury because having to sit for long periods? - Secretary Files that feature pullout drawers that contain a metal bar equipped to handle letter-size or legal-size documents are called ____. - Vertical Files Who most frequently files insurance claims and handles insu...

SNP HMO Utah Molina Medicare Options Study Exam Questions & Answers 2024 Molina Medicare Options Plus (HMO SNP) members contact - ANSWERSMember Services (888) 665-1328. They can call us 7 days a week from 8:00 a.m. to 8:00 p.m. Mountain Time. You must receive your care from a network provider. Only three exceptions: - ANSWERS1. The plan covers emergency care or urgently needed care that you get from an out-of-network provider. For more information about this, and to see what emergency o...

1. Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives Social Security benefits. How does he enroll in Original Medicare? -He can only sign up for Medicare Parts A and/or B at his local Social Security office. -He can sign up for Medicare Parts A and/or B with any licensed insurance agent. -His enrollment in Medicare Parts A and B is generally automatic if he meets all eligibility requirements -He must enroll in Medicare Parts A and B through his current...

Hartman's Chapter 1 - ANSWER-Hartman's Chapter 1 Which of the following healthcare settings is generally for people who will die in six months or less? - ANSWER-Hospice care Which of the following statements is true of long-term care? - ANSWER-Most conditions in long-term care facilities are chronic Where is long-term care offered? - ANSWER-In skilled nursing facilities A resident has purchased a special gift for her nursing assistant (NA). What would be the best response by the nu...