Utilization management is a set of methods to: a. Reduce unnecessary care b. Reduce physician-induced demand...
Utilization management is a set of methods to:
a. Reduce unnecessary care
b. Reduce physician-induced demand
c. Reduce hospital length of stay
d. A. and B. only
e. All of the above
Homework Answers
Utilization management objective is to bring efficiency in providing health care services hence they tend to achieve all objectives stated in options a,b and c hence all of the above are correcthemce option e is correct
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Utilization management is a set of methods to:
a. Reduce unnecessary care
b. Reduce physician-induced demand...
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b....
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b. resource-based relative value system. third-party administrator. d. provider network. a. C. 37. The Affordable Care Act includes which of the following categories of essential health benefins a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. 39....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b. resource-based relative value system. c. third-party administrator. d. provider network. 37. The Affordable Care Act includes which of the following categories of essential health benefits? a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. Service provided...
Assessment: The student will apply utilization guideinlines to assist in making decisions for patient care to continue,...
Assessment: The student will apply utilization guideinlines to assist in making decisions for patient care to continue, following a hospital stay, to a orthopedic rehabilitative care by evaluating 5 patient cases and record their decisions on the appropriate worksheet. Project 8-3: Use Criteria to Evaluate Appropriate Use of Healthcare Services Presume you are a health plan utilization coordinator. Your responsibilities involve evaluating the medical necessary of services, including admissions to rehabilitation facilities. The utilization guidelines you use to evaluate appropriateness...
32. Today, US a for-profit b. not-for-profit 33. What is the estimated approximate US health care...
32. Today, US a for-profit b. not-for-profit 33. What is the estimated approximate US health care waste (ie. no value)? c.65% A20% b.40% 34. The prospective hospital reimbursement system introduced in 1983 (DRGs) was an effort to: achieve cost savings by reducing excessive hospital lengths of stay 8. align Medicare payments with the actual costs of care C. provide incentives to hospitals for achieving economy in patient care costs, based upon diagnoses D. Aand C E. all of the above...
A physician send electronic care summaries to a referring physician to include medications and lab results....
A physician send electronic care summaries to a referring physician to include medications and lab results. This is an example of: A. Directed exchange B. Query-based exchange C. Consumer mediated exchange D. All of the above
Question 9 When Charlotte's ACL was torn, she visited her physician at an outpatient...
1.33 pts Question 9 When Charlotte's ACL was torn, she visited her physician at an outpatient care facility. Her doctor's decision to not recommend surgery for Charlotte and 10 other patients with similar conditions is under review by the Board of the outpatient facility. Charlotte and other patients complained that they still struggled to walk after the recovery period. What type of utilization review would identify this delivery of service? (Level 3) Oa. Prospective Utilization Review (the doctor used this...
Problem 4- Resource Utilization (16 points) Consider a demand-paged computer system using a virtu...
Problem 4- Resource Utilization (16 points) Consider a demand-paged computer system using a virtual memory management o do only main memory and disk for paging. Suppose the organization running this system can one of the following actions at the present time: afforn policy for (a) Get a faster CPU (b) Get a faster paging disk (c) Decrease the degree of multiprogramming (d) Increase the degree of multiprogramming m was measured to determine the utilization of the CPU and paging disk....
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not...
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not rendered. C. Billing for services not medically indicated or necessary D. Physician billing for services provided by interns and residents. E. Giving health care providers inducements in exchange for referrals. C Lawsuits filed by private individuals under the False Claims Act are referred to as actions. C A. All of the above. B. Whistleblower C C. Relator C D. Qui Tam The Medicare Program:...
Long-Term Care Hospitals S Check Your Understanding 11.z Answer the following questions. 1. How i...
Long-Term Care Hospitals S Check Your Understanding 11.z Answer the following questions. 1. How is the principal diagnosis assignment made in an LTCH? a. LTCH physician documentation b. Case management documentation c. STACH documentation d. Home caregiver documentation used in 2. True or False: The health record content in the LTCH setting is consistent with that a short-term acute-care facility oses than patients with a 3. Why do LTCHs patients have several more secondary diagn STACH stay? a. Longer length...
QUESTION 46 The following are all considered Outpatient Care Settings except: Oa. Office-based physician private practice...
QUESTION 46 The following are all considered Outpatient Care Settings except: Oa. Office-based physician private practice OC. Long-term care institutionalization Od QUESTION 47 2 An Advanced Directive Ob.Can either be a Living Will or a Last Will and Testament C. None of the choices are correct Od is a document that if it is in the form of a Health Care Proxy, then it is legally binding in the State of New York. QUESTION 48 2 pc The is legally...
AH Sfganization that processes claims and provides administrative services for another organization is utilization management. b. resource-based relative value system. third-party administrator. d. provider network. a. C. 37. The Affordable Care Act includes which of the following categories of essential health benefins a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. 39....
36. An organization that processes daims and provides administrative services for 1s a. utilization management. b. resource-based relative value system. c. third-party administrator. d. provider network. 37. The Affordable Care Act includes which of the following categories of essential health benefits? a. Emergency services b. Laboratory services c. Prescription drugs d. All of the above 38. Services that are needed to improve the patient's current health are considered a. elective. b. preventive. c. medically necessary. d. provider network. Service provided...
32. Today, US a for-profit b. not-for-profit 33. What is the estimated approximate US health care waste (ie. no value)? c.65% A20% b.40% 34. The prospective hospital reimbursement system introduced in 1983 (DRGs) was an effort to: achieve cost savings by reducing excessive hospital lengths of stay 8. align Medicare payments with the actual costs of care C. provide incentives to hospitals for achieving economy in patient care costs, based upon diagnoses D. Aand C E. all of the above...
1.33 pts Question 9 When Charlotte's ACL was torn, she visited her physician at an outpatient care facility. Her doctor's decision to not recommend surgery for Charlotte and 10 other patients with similar conditions is under review by the Board of the outpatient facility. Charlotte and other patients complained that they still struggled to walk after the recovery period. What type of utilization review would identify this delivery of service? (Level 3) Oa. Prospective Utilization Review (the doctor used this...
Problem 4- Resource Utilization (16 points) Consider a demand-paged computer system using a virtual memory management o do only main memory and disk for paging. Suppose the organization running this system can one of the following actions at the present time: afforn policy for (a) Get a faster CPU (b) Get a faster paging disk (c) Decrease the degree of multiprogramming (d) Increase the degree of multiprogramming m was measured to determine the utilization of the CPU and paging disk....
Examples of Health Care Fraud include: A. All of the above. B. Billing for services not rendered. C. Billing for services not medically indicated or necessary D. Physician billing for services provided by interns and residents. E. Giving health care providers inducements in exchange for referrals. C Lawsuits filed by private individuals under the False Claims Act are referred to as actions. C A. All of the above. B. Whistleblower C C. Relator C D. Qui Tam The Medicare Program:...
Long-Term Care Hospitals S Check Your Understanding 11.z Answer the following questions. 1. How is the principal diagnosis assignment made in an LTCH? a. LTCH physician documentation b. Case management documentation c. STACH documentation d. Home caregiver documentation used in 2. True or False: The health record content in the LTCH setting is consistent with that a short-term acute-care facility oses than patients with a 3. Why do LTCHs patients have several more secondary diagn STACH stay? a. Longer length...
QUESTION 46 The following are all considered Outpatient Care Settings except: Oa. Office-based physician private practice OC. Long-term care institutionalization Od QUESTION 47 2 An Advanced Directive Ob.Can either be a Living Will or a Last Will and Testament C. None of the choices are correct Od is a document that if it is in the form of a Health Care Proxy, then it is legally binding in the State of New York. QUESTION 48 2 pc The is legally...
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