Fee for service model - Study guides, Class notes & Summaries

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/...

Reimbursement Methodologies Exam 3 Questions and Answers Already Passed What does "reimbursement methodology" refer to in healthcare? a. The process of hiring healthcare providers b. The system used to determine how healthcare providers are paid for services rendered c. The coding systems for diagnoses d. The administrative tasks involved in patient care How do managed care organizations typically influence reimbursement? a. By negotiating payment rates and controlling healthcare c...

AIPMM CPM Certification Questions and Answers Rated A+ Product lifecycle stages 1. Introduction 2. Growth 3. Maturity 4. Decline Product manager Product Managers investigate, select, and drive the development of products for an organization, performing the activities or product mgmt. Product Marketing Manager Act as the voice of customer to the rest of the product team and company. Business Model Framework that describes the rationale of how an org. creates, delivers, and captures value Reas...

Chapter 9 Reimbursement Questions and Answers Graded A+ How do third-party payers affect the healthcare reimbursement process? Third-party payers, such as insurance companies, facilitate payments to healthcare providers on behalf of patients, often based on pre-negotiated rates. Why is accurate medical coding essential in the reimbursement process? Accurate medical coding ensures that healthcare providers are properly reimbursed by translating diagnoses and procedures into codes t...

Chapter 01: Nursing and the Health Care System Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition MULTIPLE CHOICE 1. Florence Nightingale’s contributions to nursing practice and education: a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wound...

Question: 1 NRNP 6675 Week 11 Fall Final Exam Questions and Verified Answers 2024/2025 Concerns when treating geriatric patients with psychotherapeutic drugs include all of the following EXCEPT: A. Elderly persons may be more susceptible to adverse effects of psychotherapeutic drugs. B. Elderly persons may metabolize psychotherapeutic drugs more slowly. C. Elderly persons may metabolize psychotherapeutic drugs more rapidly. D. Elderly persons may excrete psychotherapeutic drugs more slo...

Minnesota Cosmetology Laws & Rules flashcards Questions and Answers 2023 Clean Free from all soil, dirt; washed w/ soap and hot water Good repair Item is clean, w/ no holes, frayed wires, or tears and fully operational Unregulated service Ear piercing, body wrapping, permanent depilitation, tattoing, artificial tanning, services incidental to theatrical productions,mortuary practices, massage services, hair braiding Unregulated services signage Clearly identified, poste...

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...

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...

Accountable Care Organization (ACO) - Answer-An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee-for-service program Purpose: improve delivery of care and save costs Coordination of care Shared Savings Program - Answer-ACO payment is made for participants under fee for service who meet performance standards while lowering costs advance payment model - Answer-ACO a suppl...