a. Prepare Samson's journal entries for (a) the January 1 issuance and (b) the December 31 recognition of interest. which of the following are considered the forerunner of what we now call health maintenance organizations? B- Statistical significance TF Employer Group Benefits Plans are a form of Entitlement Benefits Programs True 8. Hospitals & Oilwell_______b.Trademark_______c.Leasehold_______d.Goldmine_______e.Building_______f.Copyright_______g.Franchise_______h.Timberland_______i. What Is PPO Insurance. Hospital utilization varies by geographical area. Considerations for successful network development include geographic accessibility and hospital-related needs. B- Ambulatory care setting Answer B refers to deductibles, and C to coinsurance. B- New federal and state laws and regulations, T/F . Costs of noncatastrophic, recurring outpatient care have risen significantly in the past few decades. C- Through the chargemaster *900 mergers. Key common characteristics of PPOs do not include: TF The GPWW requires the participation of a hospital and the formation of a group practice, Commonly recognized types of HMOS include all but, Most ancillary services are broadly divided into the following two categories, TF A Flexible Savings Account (FSA) is the same as a Medical Savings Account (MSA). \hline & \textbf{May 31, 2016} & \textbf{June 30, 2016}\\ Course Hero is not sponsored or endorsed by any college or university. There are different forms of hospital per diem . Which organization(s) need a Corporate Compliance Officer (CCO)? electronic clinical support systems are important in disease management, T/F C- Consumer choice & Utilization management considerations for successful network development include geographic accessibility and hospital related needs, state and federal regulations consistently apply network access standards to: D- A & C only, basic elements of credentialing include: c. A percentage of the allowable charge that the member is responsible for paying. Total annual out-of-pocket expenses (other than premiums) for covered benefits not to exceed $6,250. COST. This may include very specific types . The HMO Act of 1973 did contributed to the growth of managed care. In what model does an HMO contract with more than one group practice provide medical services to its members? b. most of the care in disease management systems is delivered in inpatient settings since the acuity is much greater, T/F C- Prospective review They do not apply to self-funded benefits plans, Medicare or (usually) Medicaid. D- All of the above, 1929 B- Increasing patients A- Utilization management C- Reduction in prescribing and dispensing errors In What year was the Affordable Care Act signed into law ? POS plans offer several benefits found in both HMO and PPO plans. Two desirable outcomes of tiered prescription member copayments are: The use of less expensive generic drugs increases and members save money by paying lower Tier 1 generic copayments. On IDs may not operate primarily as a vehicle for negotiating terms with private payers. Main Characteristics of Managed Care MCOs manage financing, insurance, delivery, and payment for providing health care: Premiums are usually negotiated between MCOs and employers. C- Laboratory and therapeutic _______a. B- A broad changing array of health plans employers, unions, and other purchasers of care. medicaid expansion for ALL families and individuals with incomes of less than 133% of poverty level. EPOs share similarities with: PPOs and HMOs. All managed care organizations supervise the financing of medical care delivered to members . Managed Care Managed careis a system of health care delivery that (1) seeks to PPOs came into existence because the oversupply of hospital beds and . Coinsurance: A percentage of the total of what the plan covers that the member is responsible for paying A Health Maintenance Organization (HMO . In January 2006, what large federal prescription drug program was implemented that offered pharmacy benefits to more than 40 million people at that time and is expected to increase by 30% throughout the next decade? In the medical management area, committees serve to diffuse some elements of responsibility and allow important input from the field into procedure and policy or even into case-specific interpretation of existing policy. The survey includes questions on the cost of health insurance, health benefit offer rates, coverage, eligibility, plan type enrollment, premium contributions, employee cost sharing . Manufacturers Key common characteristics of PPOs include: Prepayment for services on a fixed, per member per month basis. Coverage limitations, A fixed amount of money that may be put towards a benefit. The purpose of this research paper is to compare health care systems in three highly advanced industrialized countries: The United States of America, Canada and Germany. A reduction in HMO membership and new federal and state regulations. Consumer choice C- Requires less start-up capital the balanced budget Act of 1997 resulted in major increase in HMO enrollment. (PPOs) administer the most common types of managed care health insurance plans. D- A & B only, why is data analysis an increasingly important health plan function? Direct contracting refers to direct contracts between the HMO and the physicians. Medical Directors typically have responsibility for: Nurse-on-call or medical advice programs are considered demand management strategies True or False, It is possible for a specialist to also act as a primary care provider. (also, board certification), what does an HMO consider when selecting a hospital during the network development? C- Mission clarity The term "moral hazard" refers to which of the following? C- Reduced administrative costs, A- A reduction in HMO membership Which of the following accounts does a manufacturing company have that a service company does not have? How much of your care the plan will pay for depends on the network's rules. The Public-Private Partnership Legal Resource Center (PPPLRC) formerly known as Public-Private Partnership in Infrastructure Resource Center for Contracts, Laws and Regulations (PPPIRC) provides easy access to an array of sample legal materials which can assist in the planning, design and legal structuring of any infrastructure project especially a project which involves a public-private . See full answer below. false commonly, recognized types of hmos include all but Phos Most ancillary services are broadly divided into the following two categories.
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