Understanding Health Insurance: A Guide to Billing and Reimbursement
14th Edition
ISBN: 9781337679480
Author: GREEN
Publisher: Cengage
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Which type of health plan would allow a health maintenance organization (HMO) member to
seek care outside of the provider?
Staff model HMO.
Network model HMO.
Health saving account.
Point of service network.
Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting, and analysis of medical error that often leads to adverse effects.
Question options:
True
False
Patient care is directly related to quality. Quality improvement starts with understanding what needs to be improved on. Can you provide an example of patient-generated data and explain how patient-generated data can help to improve care delivery.
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- A physician focusing on the general medical care of hospitalized patients is known as a/an ____________. intensivist emergency physician hospitalist general practitionerarrow_forwardWhich type of health plan would allow a health maintenance organization (HMO) member to seek care outside of the provider? ● Point of service network. OO Staff model HMO. Health saving account. Network model HMO.arrow_forwardManaged care has had an impact on the healthcare industry since its inception. It introduced different managed care models as well as different payment systems. More directly, managed care has changed patient and provider behavior in terms of what they can and can’t do. Healthcare providers have been directly impacted in the way they are reimbursed and the factors that lead to maximum reimbursement. Conduct research on how the role of the physician has changed with the advent of managed care. Write a 4-5-page paper that addresses the following: Explain how managed care has changed the healthcare landscape. Discuss how managed care impacts provider reimbursement. Describe how the relationship between physician and patient has changed through managed care. Explain whether, in your opinion, the new focus on healthcare outcomes is better or worse. Discuss who benefits from the new reimbursement approach. Describe the relationship between first, second, and third-party in a managed care…arrow_forward
- True or false: People less than age 40 use the majority of long-term care services in the United States.arrow_forwardDevelop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solutionarrow_forwardProviders should not adapt advice to both the situation and the patient. Group of answer choices True Falsearrow_forward
- How beneficial is it to look for information about health online? What kinds of technical hurdles must patients overcome when deciding between in-person and remote treatment?arrow_forwardWhen asked the difference between a health maintenance organization (HMO) and a preferred provider organization (PPO) plan, what would be the correct response? A patient with a PPO plan will have no additional costs for services. An HMO provides better access to outpatient services and drug benefits. The two plans are essentially the same. A patient may choose any physician with an HMO plan.arrow_forwardIn brief Provide an example of a healthcare ethical issue, and explain what ethical principle or principles are most appropriate for resolving the issue.?arrow_forward
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