Retrospective rating Study guides, Class notes & Summaries

Nursing Informatics Certification Exam, ANCC Informatics, ANCC Nursing Informatics Certification Review 629 Questions with Answers Meta structure of NI - CORRECT ANSWER The ability of the nurse to utilize data, information, and knowledge to make wise clinical decisions. Definition of Nursing Informatics - CORRECT ANSWER A speciality that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and ...

Rules of Construction Help to identify and establish the intent of the parties to the contract Utmost good faith Each party is entitled to rely on the representation of the other, and each party should have a reasonable expectation that the other is acting in good faith without attempts to conceal or deceive. Aleatory Contract A contract under which one party's performance is contingent on an uncertain event. property and casualty agent has the power to bind the insurer...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-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 - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

Test Bank for Intermediate Accounting, Volume 2 5e 5th edition by Kin Lo, George Fisher. ISBN-13: 4919 Full Chapters test bank included for Vol 2 Chapter 11 Current Liabilities, Non-Financial Liabilities, and Contingencies A. Introduction B. Definition, Classification, and Measurement of Liabilities 1. Liabilities defined 2. Recognition 3. Financial and non-financial liabilities 4. Current versus non-current liabilities 5. Initial and subsequent measurement C. Current Liabilities ...

Property and Casualty Insurance Basics Latest 2024 Graded A+ INSURABLE INTEREST an economic interest in a property that must exist at the time of loss (you can insure the equity interest in your own home) UNDERWRITING classifies the applicant based upon the underwriting requirements of the insurer; matches the risk presented with the premium charged by the insurer LOSS RATIO percentage of claims paid in comparison to total premiums collected during a particular period of time R...

Rate - The price of insurance per exposure unit that, when multiplied by the number of exposure units, determines the premium. Rating Plan - A set of directions that specify criteria of the exposure base, the exposure unit, and rate per exposure unit to determine premiums for a particular line of insurance. Expense Loading - The element in the gross rate that covers the insurer's underwriting expenses, profits, and contingencies. Pure Premium - The amount included in the rate per exposure...

Apparent Authority - The appearance or the assumption of authority based on the actions, words, or deeds of the principal or because of circumstances the principal created. According to the state regulations pertaining to claim settlements, after receiving a notification of claim from an individual policyholder, the insured must acknowledge the notice within how many days? - 10 working days (business days) . (DRPL) Designated Responsible Licensed Person - Responsible for insurers complianc...

One distinguishing feature between independent agency systems and other marketing systems is the... agency expiration list Foreign Insurer An insurer licensed to operate in a state but incorporated in another state Domestic Insurer An insurer doing business in the jurisdiction in which it was incorporated Alien Insurer An insurer domiciled in a country other than the US Direct Response Marketing System Greatly reduces compensation costs but has higher advertising costs Agency Expiration L...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

HSC 111 Final Exam - Questions and Answers (Complete Solutions) What is the central role of health services financing in the United States? a. Fund health insurance b. Underwrite medical risk c. Support managed care d. Balance the supply of health care professionals What is the primary mechanism that enables people to obtain health care services? a. Availability of services b. Health insurance c. Payment for services d. Control of expenditures The phenomenon called 'moral hazard' results dir...