A) physical therapist C) social worker B) speech therapist D) respiratory therapist, 15. Which of the following statements accurately describes the activation of federal agencies in disasters? CDHPS have become a popular alternative to the increased costs of traditional health insurance premiums and the limitations associated with managed care plans. National Committee for Quality Assurance (NCQA). The nurse may make a referral to what member of the healthcare team? Case managers do not use the nursing process. A. Correctly identify disorders of the wrist. 4. A "health care system which attempts clinically and financially to control primary health care services in a medical group practice through elimination of redundant facilities and services for the purpose of reducing costs" describes which of the following health care financing systems? Free Clinical Skills Flashcards about Intro Final Exam Do you think Krauthammer fairly characterizes libertarian thinking? Managed care can now be categorized according to six models: 1. Health care is provided by individuals who are not employees of the HMO or who do not belong to a specially formed medical group that serves the HMO. which of the following statements describes managed care? managed care. Out-of-pocket payments for health care expenses, which are made after the tax-exempt account is expended and before the deductible for high-deductible insurance has been met; this tier actually represents a gap in coverage D. Allowing people to smoke in barns. plan in order for the plan to satisfy the ratio test? universal health insurance. B. Why is this plan called a third-party payer? Included in HEDIS is the________, which measures members' satisfaction with their care in areas such as claims processing, customer service, and getting needed care quickly. D) Medicare and Medicaid will pay most of the costs. c. proximal carpals Smallville Mall's insurer knows the existence, Insurable interest may exist when Select one: a.Julia has insurance on a car she just sold, b.Wells Fargo bank lends Tien $300,000 to buy a house and buys insurance on the house, c.Anthony, a, Assume that the following probability distribution exists for automobile damages. Also write ELL above each elliptical clause. C) Reimbursement is usually based on fee-for-service. C. The most likely route of entry of a Foreign Animal Disease is from wind blowing the agent across the borders. C. Only if flowing water is above your waist is it too high to cross. The US is the only developed nation without a system of universal healthcare, with a large proportion of its population not carrying health insurance, a . Buildingsshould be separated by at least 30 to 50 feet to prevent snowdrifts developing between them. What is Managed Care? | Cigna D. All of the above. D.Carcassesmust be disposed of onsite. es importante los pasajeros seguir las instrucciones de seguridad is a physician or health care facility under contract to the managed care plan. D) Risk management is a spontaneous response to an unexpected incident. A. C. Emergency loans from the USDA in disasters are managed by the Farm Service Agency. HMO a. information disclosure regulation b. establishing minimum standards and monitoring compliance, The Smallville Mall has assumed the responsibility for payment of liability losses caused by Chuck's Famous Pizza to attract the pizza chain to the mall. Exclusive provider organization (EPO) patients must receive care from participating providers, which can include emergency departments at participating hospitals, or they pay for all costs incurred. . Managed care plans implement _______ as a method of controlling health care costs and quality of care. 2.15) Which of the following allied health professionals practice medicine under the direction and responsible supervision of providers and surgeons? Which of the following statements iscorrectregarding the human food supply in disasters? B. Managed care plan enrollees receive care from a ________ selected from a list of participating providers. Medical practice that treats disease, such as medications and surgery Allopathic Individual contributes to the injury or condition Contributory negligence A person under the age of 18 who has been legally separated from his/her parents Emancipated minor Discontinue medical care without proper notice after accepting a patient Abandonment define employer contributions and ask employees to be more responsible for health care decisions and cost-sharing. B. Citizens discuss the ideal of equal access to health care for everyone, including care for indigents. The group plan will pay depending on the employee's recovery C. The group plan will not pay because the employee was injured at work D. The group plan will pay C. "Sign up for childbirth classes." c. "Sign up for the WIC program." d. "Take your prenatal vitamins daily." A Exam 1 Review Questions Flashcards by Cam Bui | Brainscape II. 17. 2.12) Which of the following does not apply to the role of a medical assistant? Visibility, because only external customers should be considered. E) In the past, healthcare focused primarily on prevention of illnesses since it was covered by insurance. 17. The response to transportation accidents often requires coordination among law enforcement, fire department, emergency management, the hauler and owner. c.Health insurance must be This problem has been solved! B) The contribution rate is fixed, and the retirement benefit is known in advance. 3. EJEMPLO: Es probable que nosotros evitemos una tempestad. 12. How would the nurse respond? D. All of the above. Professional standards review organizations (PSROs). Which of the following statements will NOT reduce risks arising from wildfires? 30. C. The number of animals that need to be evacuated from a farm is an important factor in determining how quickly a farm can be evacuated. Utilization management activities include: preadmission certification (PAC) or preadmission review, preauthorization, concurrent review, and discharge planning. [The work functions are Ta (6.811019J)\left(6.81 \times 10^{-19} \mathrm{~J}\right)(6.811019J), Ba(4.301019J)\mathrm{Ba}\left(4.30 \times 10^{-19} \mathrm{~J}\right)Ba(4.301019J), and W (7.161019J)\left(7.16 \times 10^{-19} \mathrm{~J}\right)(7.161019J); work function is explained . In outbreaks reported from acute care settings in the U.S. following implementation of unive. Institution - Wikipedia Who would be most likely to teach the classes? The federal _________ plan requires managed care plans that contract with Medicare or Medicaid to disclose information about ________ plans to CMS or state Medicaid agencies before a new or renewed contract receives final approval. Up-to-date lists of patient copayments and fees for each managed care plan contract Special patient interviews to ensure preauthorization and to explain out-of-network requirements if the patient is self-referring True: Name 3 of the primary purposes of the health record. Solved Question 69 (1 point) Which of the following | Chegg.com B) Employers, insurance companies, and other health insurance benefit providers are typical groups that contract with PPOs. The Ultimate Anime Girl Names Generator + Meanings Aiko to Zakuro! B. A. Medicare was established in 1965 under Title XVIII of the Social Security Act as a federal health insurance program for individuals age 65 and older, regardless of income or health status. D. FEMA is responsible for reducing and reimbursing all personal losses in disasters. 29. Institutions (singular: institution) are humanly devised structures of rules and norms that shape and constrain individual behavior. An important role of FEMA in disasters is coordination of response and recovery activities in declared major disasters. _______ were created to manage benefits and to develop participating provider networks. If enrollees choose to receive all medical care from the managed network of health care providers, or obtain an authorization from their POS primary care provider for specialty care with an out-of-network provider, they pay only the regular copayment or a small charge for the visit and they pay no deductible or coinsurance costs. D) Pension benefits attributable to the employer, s contributions are not taxed until the employee retires or, 2) Beta Corporation has 1,000 employees eligible to participate in the firm, employees are considered highly compensated. Consumer-directed health plans (CDHPS) provide incentives for controlling health care expenses and give individuals an alternative to traditional health insurance and managed care coverage. Under extreme heat conditions, livestock require less than 10%body weightof water per day. What is the minimum number of the 900 non, highly compensated employees who must be covered by the. As she pays her co-payment, she says "Oh dear, the doctor told me to see someone, but I can't remember what he said. C) Short- and long-term results of cost-containment measures are undetermined. Continuing Healthcare Funding issues - why isn't it simple to apply? A) primary care B) respite care C) bereavement care D) palliative care, 12. B. Designating access to barns and water for firefighters. Funds in an FSA are exempt from both income tax and Social Security tax (employers may also contribute to FSAS). 7. Cambodia Crime. 2.20) Which of the following is not recognized by the WHO as potentially treatable by acupuncture? Contracted health care services are delivered to subscribers by individual physicians in the community. FEMA IS 111.A: Livestock in Disasters Answers Individual Practice Association (IPA) HMO Network Model HMO. D. All of the above. B. b. distal radius Which of the following statements iscorrectregarding a Foreign Animal Disease outbreak? A) The insurance company pays all or most of the costs. A primary care provider (PCP) assigned to each subscriber is responsible for coordinating health care services and referring subscribers to other health care providers. utilization review organization (URO), third-party administrator (TPA). Which terms best describes those who receive managed health care plan 1 . Local plans allow communities to integrate with state and federal response to disasters. An elderly woman has total care of her husband with Alzheimer's disease. Prior to scheduling elective surgery, managed care plans often require a _______; that is, a second physician is asked to evaluate the necessity of surgery and recommend the most economical, appropriate facility in which to perform the surgery (e.g., outpatient clinic doctor's office versus inpatient hospitalization). A coup d'tat (/ k u d e t / (); French for 'stroke of state'), also known as a coup or an overthrow, is a seizure and removal of a government and its powers. Doctors Without Borders The ________ (e.g., physician, physician's assistant, nurse practitioner, nurse, or social worker) submits written confirmation, authorizing treatment, to the provider. b. Which of the following statements accurately describes the clinical nurse leader (CNL)? plans emphasize cost control, total health benefit costs continue to increase. e. Staff model MA NCCT EXAM Flashcards | Quizlet C) Employer contributions are considered taxable income to employees but are taxed at capital gains rates. Provide quality health care while containing costs. The appropriateness, efficiency, and medical necessity of health care provided to patients is reviewed on a prospective and retrospective basis. The National Committee for Quality Assurance (NCQA) evaluates managed care organizations. Which of the following statements accurately describe an aspect of managed care? A. Floodwaters are frequently contaminated with hazardous chemicals. PPOS do not routinely establish contracts for laboratory or pharmacy services, but they do offer reduced-rate contracts with specific hospitals. Individual decides, in advance, how much money to deposit in the HCRA (unused funds are forfeited). Large-scale disposal ofcarcassescan be contracted to specialty firms that deal with hazardousmaterialsdisposal, such as from superfund sites. Staff Model HMO Individual Practice Association (IPA) HMO. Yet, segments of the health care system maintain aspects of a free-market competition. A patient who requires treatment for breast cancer is referred to an oncologist. The report card contains data regarding a managed care plan's quality, utilization, customer satisfaction, administrative effectiveness, financial stability, and cost control. If there is a boil-water order in effect, do not drink or give animals tap water unless you know it is safe. fixed, but the retirement benefit is not known in advance. C. Veterinarians dont know much about the clinical aspects of food animals exposed to hazardous chemicals. Managed care plans also require the development of patient care plans for the coordination and provision of care for complicated cases in a cost-effective manner, which is called __________. (sometimes called a participating provider organization) is a managed care network of physicians and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee. Metal A emits electrons in response to visible light; metals B\mathrm{B}B and C\mathrm{C}C require UV light. Which of the following statements about risk management is true? Damage from mudflows cannot be covered by insurance. Which of the following statements iscorrectregarding hurricanes? C) The nurse is considered the "gatekeeper" in the managed care system. Medicare beheficiaries are entitled to advice from their physicians on medically necessary treatment options that may be appropriate for their condition or disease. 20. B. Livestock that are adapted to cold can tolerate low temperatures if they have adequate feed intake. a. Chapter 2 Quiz Flashcards | Quizlet Study Resources. 6. Tax-exempt accounts that are offered by employers with 50 or more employees, which individuals use to pay health care bills. B) The care of the patient is carefully planned and monitored by the primary care provider. The Incident Command System provides a consistent method to respond to all types of emergencies. Health risk assessment instruments (surveys) and resources are also available to subscribers. . 11. 2.4) Which of the following best describes the process of screening in the medical office setting? Relationships are not critical in the delivery of health services. It is also called a cafeteria plan (or flexible benefit plan) because of the different benefit plans and extra coverage options provided through the insurer or third-party administrator. 5) Two parameters that usually result in an indication of excellent health are: A) genetics and education. True or false? Ch. 3 Managed Health Care Flashcards | Quizlet It lowers cost through the elimination of waste and excess. which of the following statements describes managed care? 2.9) Which of the following is an eye specialist? A. B. Composting is no longer used to dispose of any livestockcarcasses. HSA stands for health savings account, and HSA-qualified plans can be HMOs, PPOs, EPOs, or POS plans. Purchasing a generator as an alternative power supply. Select all that apply. efficient and lower cost manner. A. 8. C) education and income. Which of the following statements about managed care are true? If the physician provides services that cost less than the capitation amount, there is a profit (which the physician keeps). Compute the expected value of the damages and fill in the chart below. The owner of an escaped animal may be held liable for damages his/her animal creates. The National Committee for Quality Assurance (NCQA) reviews managed care plans and develops report cards to allow health care consumers to make informed decisions when selecting a plan. The term used to describe sophisticated and highly complex medical care is. Which of the following statements describes cyberwarfare? In economic terms, taxation transfers wealth from households or businesses to the . Medicare established the __________ to ensure the accountability of managed care plans in terms of objective, measurable standards (requirements). Hazardous materials released during floods will flow away with the water. Accreditation organizations develop standards (requirements) that are reviewed during a survey (evaluation) process that is conducted both offsite (e.g., managed care plan submits an initial document for review) and onsite (at the managed care plan's facilities). Healthcare in the United States - Wikipedia 4. A) do their job and do it well B) refuse to participate in organizations C) support legislation to improve care D) become a member of a support group, Julie S Snyder, Linda Lilley, Shelly Collins. 2.4) Which of the following best describes the process of screening in the medical office setting? 20. Health care can be purchased or given freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable people. d. 2.13) Which of the following best describes the purpose of managed care? Select all that apply. Choose the correct description or cause of pharyngitis. 9. The early retirement age is the earliest age at which an employee can. Hint and warning: Do not use lower limits on your integrals 1n2n3+1\sum_{1}^{\infty} \frac{n^{2}}{n^{3}+1}1n3+1n2. If an employee changes jobs, he or she can continue to use the HRA to pay for qualified health care expenses. Tax - Wikipedia The group plan will pay a portion of the employee's expenses B. Healthcare in the United States is far outspent than any other nation, measured both in per capita spending and as a percentage of GDP. d. Then, identify the type of clause by writing one of the following abbreviations above it: ADJ for adjective clause, ADV for adverb clause, or N for noun clause. is an organization of affiliated providers' sites (e.g., hospitals, ambulatory surgical centers, or physician groups) that offer joint health care services to subscribers. Which of the following statements are considerations for managed care organizations? (a) CO\mathrm{CO}CO, (b) O2\mathrm{O}_2O2, (c) H2S\mathrm{H}_2 \mathrm{~S}H2S, (d) SiH4\mathrm{SiH}_4SiH4, and (e) CHCl3\mathrm{CHCl}_3CHCl3. C. Planting deep-rooted ground cover is an effective mitigation measure against landslides. An integrated delivery system may also be referred to by any of the following names: integrated service network (ISN), delivery system, vertically integrated plan (VIP), vertically integrated system, horizontally integrated system, health delivery network, or accountable health plan. 51 which of the following statements about managed - Course Hero A) the healthcare institution itself C) American Medical Association B) Board of Healing Arts D) State Board of Nursing, 14. 16. OPEN-PANEL HMO, Direct Contract Model. Which of the following is NOT relevant to the care of animals in floods? D. Floods are an uncommon cause of natural disaster in the United States. D. Intensification and consolidation has resulted in an increased number of animals living in a smaller space. D. All of the above. Which of the following statements is correct about the behavior of landslides? a) managed care. B) The care of the patient is carefully planned and monitored by the primary care provider. Laws, rules, social conventions and norms are all examples of institutions. B. Thunderstorms and their consequences are common, but rarely create problems. Which of the following is a natural consequence of utilitarian forms of health care financing? Point-of-service plan (POS) Answer: The IPA is an intermediary (e.g., physician association) that negotiates the HMO contract and receives and manages the capitation payment from the HMO, so that physicians are paid on either a fee-for-service or capitation basis. These range from structured staff model HMOS to less structured preferred provider organizations (PPOS). 2. The _______ is responsible for supervising and coordinating health care services for enrollees and approves referrals to specialists and inpatient hospital admissions (except in emergencies). Which of the following is one of those responsibilities?