You must tell her that a Private Fee-for-Service (PFFS) plan may affect her access to services to vary the provider's pay rates solely based on the provider's specialty or location or to increase usage of certain preventive or sorting
What is the Private Fee-For-Service (PFFS) plan?A Private Fee-For-Service (PFFS) plan is a Medicare Advantage (MA) health plan offered by a state-licensed risk entity that has an annual contract with the Centers for Medicare & Medicaid Services (CMS) to provide all your Medicare benefits, in addition to any additional benefits the company chooses to provide, to beneficiaries. The PFFS plan:
• Pays providers on a fee-for-service basis without putting providers at financial risk
• Vary provider payment rates solely based on provider specialty or location or to increase utilization of certain preventive or screening services
• Does not restrict participants' choice among providers legally authorized to provide services and accept the plan's payment terms and
• Does not allow the use of prior authorization or notification.
With this information, we can conclude that you must tell her that a Private Fee-for-Service (PFFS) plan may affect her access to services to vary the provider's pay rates solely based on the provider's specialty or location or to increase usage of certain preventive or sorting
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Answer:
d. Medicaid may provide additional benefits, but Medicaid will only pay for these services if they are furnished by Medicaid participating providers.
Explanation: Medicaid participants can only work with providers that work with medicaid.
Write a one page paper on the education and training for Clinicians.
The most crucial workers in the healthcare industry are medical clinicians. In the majority of healthcare systems, they are regarded as the primary healthcare providers. Reaching this standard is difficult or impossible in the US. It requires a lot of work.
What is the role of medical clinicians?A clinician focuses on offering patients with various disorders direct care, diagnosis, and therapy. The primary responsibilities of a clinician include doing in-depth research and analysis, offering medical care through a variety of therapies, and enhancing patients' general health.
They should enroll in a four-year undergraduate program.
Following four years of medical school, a resident trainer will work for three to seven years. Following that, they may apply for a license and begin working.
They should participate in an ongoing medical education program to stay current on new developments. Both undergraduate students and recent grads must go through this training. It typically pertains to broad education. Ambulatory care training is available for students.
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Mrs. Reynolds is in her Medicare initial coverage election period (ICEP) and the date of her entitlement to Part A and B has already occurred. Mrs. Reynolds has just signed up for a Medicare Advantage plan on the second of the month. She is leaving for vacation in two weeks and wants to know if her new coverage will start before she leaves. What should you tell her?
Explanation:
a. Typically, her coverage would begin on the first day of the next month, so she should not expect her coverage to begin before she leaves.
b. Typically, her coverage would begin 30 days after she submits the application form, so she should not expect the coverage to begin until after she leaves.
c. Coverage always begins on the first of July, or the first of January after a beneficiary enrolls, whichever comes first.
d. Typically, coverage is effective on the date that the beneficiary completes the application form, so her coverage will be in place before she leaves
A. She shouldn't expect her coverage to begin before she leaves the company, as her coverage usually begins on the first day of the following month.
b. Normally, her coverage starts 30 days after you submit her application, so you shouldn't expect it to start before your departure.
c. Coverage always begins on July 1st or January 1st, whichever comes first, after the beneficiary has registered.
d. Compensation usually begins on the day the beneficiary fills out the application, so compensation is provided prior to departure.
What is Medicare's initial coverage election period?Generally, when you turn 65.
This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.
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One of your patients, 11-year-old Elizabeth, has recently been diagnosed with diabetes. She is feeling isolated and upset about the changes she is facing in her life. What are some ways you can help Elizabeth adjust to her diagnosis? What social options could you offer to Elizabeth to help her feel less isolated?
Answer:
Elizabeth can eat healthy foods such as vegetables and fruits and drink plenty of water. She can try to avoid sugar foods like sweets and sugar. She can feel less isolated by talking or spending time with family/ friends and sharing every single change she is facing in her life, so that they can help her feel better or/and even consult a doctor. Hope it helps!
Explain why billing Medicare Part A for the listed service is or is not correct.
Summarize the types of services Medicare Part A reimburses.
Discuss the type of services Medicare Part B covers.
Answer:
a
Explanation:
because it's just Rudy's fine drums cm g
Part A is hospital coverage, while Part B is more for doctor's visits and other aspects of outpatient medical care. These plans aren't competitors, but instead are intended to complement each other to provide health coverage at a doctor's office and hospital.
What is meant by outpatient medical care?Outpatient care the kind that you don't have to stay in a hospital for can vary greatly. Other than an annual check-up or blood test, almost any other kind of care can be defined as outpatient. These may be diagnostic tests, treatments, or other types of procedures.Part A is hospital coverage, while Part B is more for doctor's visits and other aspects of outpatient medical care. These plans aren't competitors, but instead are intended to complement each other to provide health coverage at a doctor's office and hospital.
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Select the correct answer.
Which action can
trigger lactic acid fermentation in our bodies?
O A. drinking coffee
O B. reading a book
O C. running a marathon
O D.
sleeping
O E. watching a movie
21
Quentin is practicing self-management for his health. What is MOST likely to be the FIRST step in this process?
OA. He should consult a physician.
He should talk with a friend.
OC.
B.Heshould monitor how he is feeling.
OD. He should make a plan to get active.
Answer:
he should monitor how he is feeling
There are four known types of somatotypes.
True
False
Describe the difference between research and quality improvement. Provide a workplace example where qualitative and quantitative research is applied and how it was used within your organization.
Research differs from Quality improvement in that research involves the process of learning new ideas while Quality improvement involves making something better.
What the difference between research and quality improvement?Research is the process of learning new ideas or establishing facts by careful studies and analysis,
Quality improvement is the process of making something better. Quality improvement usually involves doing research.
A food shop can conduct quantitative research by getting data of number of people who visit their shop to buy a new food product but can conduct qualitative research by asking the people how the feel about the new product.
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Which of the following statements regarding the circulation of blood are true and which are false?
The statements regarding the circulation of blood are as follows:
Pulmonary circulation begins at the left atrium and ends at the right ventricle. (False)The systemic arteries begin as branches of the aorta. (True)The amount of blood that circulates through an organ increases as the organ becomes more metabolically active. (True)Systemic circulation begins at the left ventricle and ends at the right atrium. (True)The two caval veins drain blood from the body, except for the head. (False)Blood flows slows in capillaries but speeds up in veins. (True)Hepatic portal circulation enables the liver to store or modify substances in the blood coming from the digestive organs and spleen. (False)Blood in veins is kept moving by external forces as well as constriction of the veins themselves. (False)What is Blood circulation?Blood circulation may be defined as the physiological transportation methodology of arterial and/or venous blood through the vascular system and the heart chambers.
Therefore, each of the statements about blood circulation either true or false is described above.
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