Managed care exam 3 - Study guides, Class notes & Summaries

ANCC Risk mgt / ethics / research Exam 93 Questions with Verified Answers What are some systematic components to reducing risk? What does it begin with? - CORRECT ANSWER Begins with a formal written plan -organizational goals -delineation of program scope, components, methods -delegating responsibility for implementation and enforcement -commitment of the board -guarantees of confidentiality and immunity for those who squeal goals -> scope/methods -> delegation -> board b...

Focused Exam: Abdominal Pain Esther Park shadow health assignment from experts with ALL SECTIONS required Esther Park is a 78-year-old Korean woman presenting with abdominal pain in the ED. the abdominal pain is a 6 and described as a constant dull, crampy feeling low low in her abdomen that began as a general discomfort about 5 days ago when the patient states she began having difficulties going to the bathroom and has not had a bowel movement for several days. The pain worsens when she m...

AIPMM CPM Certification Exam Questions and Answers 100% CorrectAIPMM CPM Certification Exam Questions and Answers 100% CorrectAIPMM CPM Certification Exam Questions and Answers 100% Correct Product lifecycle stages - ANSWER-1. Introduction 2. Growth 3. Maturity 4. Decline Product manager - ANSWER-Product Managers investigate, select, and drive the development of products for an organization, performing the activities or product mgmt. Product Marketing Manager - ANSWER-Act as the voic...

NR 228 Week 1 Exam: Latest Questions With Answers | Latest Updated 2023/2024 | Graded A+. Which principle of health diet suggest selecting a wide range of foods as represented by the USDA’s MyPlate food plan? a) Variety b) Moderation c) Adequacy d) Energy density 2. A group of strategies used to increase the level of health of individuals, families, groups and communities is known as: a) Wellness b) health promotion c) tertiary prevention d) nutritional assessment 3. Food descripti...

NP Role Final Exam 159 Questions with Verified Answers In which specialty are most nurse practitioners educated? Peds Primary care Family Adult gerontology - CORRECT ANSWER primary care Which factor represents a potential barrier to Nurse Practitioner's practice in a primary care setting? Cost effectiveness Professional growth Aging baby boomers Collaboration agreements - CORRECT ANSWER Collaboration agreements Distinguish among the advanced practice registered nursing (APRN...

Pediatric Nursing The Critical Components of Nursing Care 2nd Edition Rudd Test Bank Pediatric Nursing The Critical Components of Nursing Care 2nd Edition Rudd Test Bank 2nd Edition   Chapter 1. Issues and Trends in Pediatric Nursing MULTIPLE CHOICE 1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the pediatric setting should the nurse expect to find? a. Increased hospitalization of children b. Decreased number of uninsured ch...

UM focuses on telling doctors and hospitals what to do. correct answersFALSE The use of utilization guidelines targets only managed care patients and does not have an impact on the care of non-managed care patients. correct answersFALSE Nurse-on-call or medical advice programs are considered demand management strategies. correct answersTRUE Utilization management seeks to reduce practice variation while promoting good outcomes and _____. correct answersNone of the above Which of the ...

Exam 3: PNR207 / PNR 207 (Latest Update 2024 / 2025) Transition to PN Practice - Capstone | Review Guide Questions and Verified Answers | 100% Correct | Grade A - Fortis Question: private group health insurance Answer: a method of pooling individual contributions for a common group goal of protection from financial disaster due to health care bills ie: insurance for those of specific religions Question: Capitation Answer: System of payment used by managed care plans in which ph...

Certified Paraoptometric Coder Exam Questions and Answers Latest Guide 2024 (Already Scored 100%) Is it acceptable for a staff person to correct a CPT or ICD-10 code on a route slip or claim without the consent of the doctor? Medical Decision Making, Examination, and History - Answer What are the Key Components of E and M Coding? 51 - Answer What modifier is used if two non bundled surgical procedures are performed on the same eye at the same visit? 24 - Answer What modifier should you use...

What is the maximum amount of time an insurer has to provide the claimant the forms for filing proof of loss? 1. 7 days 2. 15 days 3. 30 days 4. 90 days - Answer- 2. 15 days Which of the following is the most common method to supplement Medicare coverage? 1. Medicaid 2. Group health insurance 3. Employer Health Insurance 4. Coverage offered by private insurers - Answer- 4. Coverage offered by private insurers In which of the following must a beneficiary change request be filed in w...