Implementation of managed care to control cost resulted in which of the following: A. PCP roles decrease B. Delay and/or denial of payment to provider claims C. Direct access to specialists D. All of the above E. None of the above
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- Seven Essential Elements of An Effective Compliance Program include: Question 21 options: A-Establishing Compliance Standards of Conduct and Procedures B-Overall Compliance Program Oversight C-Due Care in Delegation of Authority D-Monitoring and Auditing Systems E-All of the AboveA primary beneficiary would be named for which of the following types of Accident and Healin policies A B ●C. D. Travel Accident Major Medical Nursing Home Business Overhead ExpenseProvide two examples for each element: A. Expected benefits. B. Risks
- Commercial insurance policies issued with a deposit or provisional premium would be subject to O A a survey a rewrite an audit an inspection OB. OC O D.__44.. Why is quality management and the critical cycle essential to the healthcare manager??5 You are a midlevel manager at a major metropolitan hospital and are responsible for capturing and reporting statistics regarding the cost and quality of patient care. You believe in a strict interpretation when defining various reportable incidents; as a result, your hospital's rating on a number of quality issues has declined during the six months you have held the position. Your predecessor was more lenient and was inclined to let minor incidents go unreported or to classify some serious incidents as less serious. The quarterly quality meeting is next week, and you know that your reporting will be challenged by the chief of staff and other members of the quality review board. How should you prepare for this meeting? Should you defend your strict reporting procedures or revert to the former reporting process for the "sake of consistency in the numbers," as several people have urged?
- What does it mean to have the option of using an FMS?Average claim is valued at $500. 100 rejected claims over 3 months How much revenue could be potentially lost over this quarter if the medical biller does not follow-up on these rejected claims? $500 in revenue $500,000 in revenue $200,000 in revenue $50,000 in revenue113) Which of the following statements is true about value chain in clinical care? a) Reducing patient waiting time is associated with pre-service care. b) Service Excellence in the patient – Physician interaction is associated with point of service care. c) Identification of target populations is associated with point of service care d) Advertising and promotion is associated with after service care.
- Background: Data about the frequency of adverse events related to inappropriate care in hospitals come from studies of medical records as if they represented a true record of adverse events. In a prospective, observational design we analyzed discussion of adverse events during the care of all patients admitted to three units of a large, urban teaching hospital affiliated to a university medical school. Discussion took place during routine clinical meetings. We undertook the study to enhance understanding of the incidence and scope of adverse events as a basis for preventing themMethods: Ethnographers trained in qualitative observational research attended dayshift, weekday, regularly scheduled attending rounds, residents' work rounds, nursing shift changes, case conferences, and other scheduled meetings in three study units as well as various departmental and section meetings. They recorded all adverse events during patient care discussed at these meetings and developed a classification…Background: Data about the frequency of adverse events related to inappropriate care in hospitals come from studies of medical records as if they represented a true record of adverse events. In a prospective, observational design we analyzed discussion of adverse events during the care of all patients admitted to three units of a large, urban teaching hospital affiliated to a university medical school. Discussion took place during routine clinical meetings. We undertook the study to enhance understanding of the incidence and scope of adverse events as a basis for preventing them Methods: Ethnographers trained in qualitative observational research attended dayshift, weekday, regularly scheduled attending rounds, residents' work rounds, nursing shift changes, case conferences, and other scheduled meetings in three study units as well as various departmental and section meetings. They recorded all adverse events during patient care discussed at these meetings and developed a…On February 12 Peg Jones, vice president for operations and maintenance, called into Stephen’s office and asked to study the issue. Specially, Stephen wanted to know whether the average fleet age was correlated to direct airframe maintenance costs, and whether there was a relationship between average fleet age and direct engine maintenance costs. Peg was to report back by February 26 with the answer, along with quantitative and graphical descriptions of the relationship. Peg’s first step was to have her staff construct the average age of Northern and Southeast B727-300 fleets, by quarter, since the introduction of that aircraft to service by each airline in late 1993 and 1994. The average age of each fleet was calculated by first multiplying the total number of calendar days each aircraft had been in service at the pertinent point in time by the average daily utilization of the respective fleet to total fleet hours flown. The total fleet hours was then dividend by the number of…