Explanation:
I’ll describe this in simplest terms. Things can be considerably more complex that this, and many reimbursement model variants exist in between these two “extremes”Fee for Service : the provider (e.g. doctor or hospital) bills the insurer. The insurer adjudicates the claim, and reimburses the provider at rates that have been agreed upon by the two, less any portions for which the patient is held responsible per the terms if their policy.(Large provider organizations may negotiate their own reimbursement schedules with insurers. Smaller ones mostly just make “take it or leave it” decisions on whether or not they want to accept the insurer’s members as patients, based on whether the insurer’s reimbursement rates appear acceptable to them in light of how badly they need access to the insurer’s supply of patients.)In this model, all risk is carried by the insurer and its members. The insurer’s risk is that its members will require care for which it must pay out as just described. The members’ risk consists of how much they might have to pay in the form of deductibles, co-payments, and coinsurance if they require care. The providers mostly avoid risk because even if they end up treating a particularly expensive mix of patients, their revenue will go up accordingly.Capitation : the provider is compensated primarily by a flat amount - the ‘capitation amount’ - that the insurer pays to them, per member/per month. Typically there will also be co-pays that are the responsibility of the member/patient. Then it is up to the provider to do its best to manage how it treats its cap patient population so that its costs of caring for them do not exceed the corresponding cap income.In this model, considerable risk has been shifted to the provider. (Not all of it. There typically are provisions in the insurer-provider agreement that shift risk back to the insurer in circumstances of high patient utilization beyond the provider’s control. As previously noted, there can be many variants. And of course the member/patients still bear some risk with the copays etc.). This model creates incentive for the provider to think and act like they are “part provider, part insurer”. It is an “in between” model that stops short of the providers and insurer becoming one-and-the-same business (like Kaiser is, for example).Sorry for the Subheadings letters#Mark me as Brainliest AnswerProzac was one of the early
Maria has a reduced risk of having a heart attack. Which of the following may be responsible for strengthening her heart, increasing blood flow, keeping blood vessels open, and lowering her blood pressure; all of which reduce her risk of having a heart attack?
Answer:
By having a nutritious and balanced diet. Also, by excersising moderately and regularly will improve cardiovascular health.
The intensity of your workout is too difficult if your heart rate has not returned to 100 bpm within how many minutes?
a - 5 minutes
b - 10 minutes
c - 12 minutes
d - 15 minutes
Answer:
I would say 12 minutes.
Explanation:
I'm basing it off of what I learned in health which is it your heartrate would need to be at 120 within 5 so doing basic math its most likely 12.
Match each kind of drug to a relationship it has with society and culture.
Answer:
Explanation:
Antacids are heartburn/stomachache medicine. Common brand is pepto-bismol. Since this is a pharmaceutical drug, it will fit in the first box.
Cigarettes production is controlled by the government which is why it's more commonly seen in convience store. This will fit in the third box.
Beer goes into the second box because it's talking about alcoholism which comes from drinking beer.
Cocaine is an illegal which is not allowed to be produce. This will in the fourth and final box.
Films on real men
What are good films on real men who can fight
Answer:
u mean physical or mentally
What is the first step in problem-solving Approaches
Answer: Step 1: Define the Problem. What is the problem? ...
Step 2: Clarify the Problem. ...
Step 3: Define the Goals. ...
Step 4: Identify Root Cause of the Problem. ...
Step 5: Develop Action Plan. ...
Step 6: Execute Action Plan. ...
Step 7: Evaluate the Results. ...
Step 8: Continuously Improve.
Explanation:
what role does Administrative costs in higher health care ?
Answer:
One reason the healthcare administration industry is so important is because it keeps costs down. ... If a patient does not pay for medical care, the hospital may pass those costs onto other patients. Administrators can also work with a patient's insurer and find ways to cover the total cost of any services provided.
GO THROUGH THIS !
Is a speculative theory that seeks to reconceive what is human
Answer:
another human that's all I have for you sorry
A worker was just hit by a forklift. The scene is safe and you begin to assess the worker. You see that she is conscious and breathing normally, but obviously in pain. What is the purpose of doing a secondary survey on this victim?
Answer:
to make sure that the injury isn't severe and seeing if there is anything else that is broken or bleeding
Explanation:
Each of the following chronic health conditions has been linked by nutrition research to our dietary habits. In most cases, this association is linked to either excessive intake or inadequate intake of a particular nutrient or food group. Briefly identify one nutrient that has been associated with each of the following conditions, and explain whether or not it is thought to be a protective factor, or a factor that increases risk. (Do not include alcohol since its calories have no nutritive value.) . a. Hypertension b. LDL to HDL ratio: 200:30 c. B12 deficiency d. Osteoporosis e. Colorectal cancer
Answer:
Chronic diseases as diabetes. Factor that does increases risk. This disease increases hypertension. Not caring for it might increase kidney failure.
Provide an example of when a disability service worker may seek
support from more experienced and qualified staff?
Explanation:
job injury is the no.1 cause of healthcare workers needing PT + BUILDING MUSCLE 2 support injury...
Select the correct answerSelect the correct answer from each drop-down menu. A teacher is making a history test composed of the same number of multiple-choice questions as short-answer questions. She estimates it will take students an average of 2 minutes to complete each multiple-choice question and an average of 3.5 minutes to complete each short-answer question. Write an inequality to determine how many questions, n, the teacher can include if the test must take students less than 45 minutes to complete. from each drop-down menu. A teacher is making a history test composed of the same number of multiple-choice questions as short-answer questions. She estimates it will take students an average of 2 minutes to complete each multiple-choice question and an average of 3.5 minutes to complete each short-answer question. Write an inequality to determine how many questions, n, the teacher can include if the test must take students less than 45 minutes to complete. 45
The inequality to show the number of questions the teacher can include is 2x + 3.5x < 45
An inequality shows the relationship between two mathematical expressions. The first step to write an inequality is to identify the factors to consider. In this case:
Time for multiple-choice questions: 2 minutes.Time for short-answer questions: 3.5 minutes.Total time for the test: 45 minutes.Now, using this information you can create the inequality:
2x (multiple-choice questions time) + 3.5x (short-answer questions time) < 45 minutes (Total time for the test)x represents number of questions.You can also solve this equality:
2x + 3.5 x < 455.5 x < 45x < 45 / 5.5.x < 8.1This means the teacher can include 8 questions of each type.
Learn more about inequality in: https://brainly.com/question/19491153
1. What do we call the study of the earth and its structure?
Answer:
Geology
Explanation:
Answer:
Geology is the study of the Earth and its structures
What vitamin is neither fat nor water soluble
Stella was born deaf, but her parents are able to hear. Her parents also do not use sign language. When she was in middle school, she learned American Sign Language (ASL). To whom would she be MOST similar?
1.a 3-year old who learned ASL as a baby
2.an adult immigrant who learned a new language
3.an adult who learned ASL as a baby
4.a 3-year old who recently lost his hearing and is learning ASL
Answer:
2. i think
Explanation:
The observation declares that the correct answer is an adult immigrant who learned a new language.
ASl is the sign language used by Stella when she was in middle school to express or to speak. She learned ASL when she was in middle school, she learned as her parents also do not use sign language.
Wat is ASl language?American Sign Language is a herbal language that serves because of the fundamental signal language of Deaf groups withinside the United States and maximum of Anglophone Canada. ASL is a whole and prepared visible language this is expressed through facial features in addition to actions and motions with the hands.
Thus it is clear that when she was in middle school, she learned an adult immigrant who learned a new language.
To learn more about ASl refer to the link ;
https://brainly.com/question/1350132
The member of the rehabilitation team who assesses a patient nutritional needs and designed a dietary schedule for the patient is the
Answer:
What can we conclude from this graph?
Increasing temperature increases solubility for all three substances.
Increasing volume increases solubility for all three substances.
Decreasing temperature increased the solubility for all three substances.
With increasing temperature, Substance 3 decreases in solubility while Substance 1 increases in solubility.
Explanation:
What are some examples of healthy conflict management?
Answer:
Clash of personalities ,Conflicts with customers Task-based conflicts Conflict with manager’s leadership style
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A patient who had surgery earlier in the day had to wait an hour for pain medicine because the doctor forgot to
arrange for it to be available. It took an hour to find the doctor.
The doctor's action demonstrated a lack of
justice
nonmaleficence
autonomy
beneficence
Mark this and return
Save and Exit
Next
Submit
Answer:
D
Explanation:
the correct answer is Beneficence
What is a group of animals of the same species that share common traits?
A: A breed
B: A breeding
C: A Genus
D: A herd
Answer:
The answer is A a breed. ...
Amanda has started running as her primary form of exercise, but she's getting bored with it and finds excuses to procrastinate. It's also getting really hot outside now that it's summer, and Amanda's skin is sensitive to the sun. She has a significant budget available to help her fix the problem but is unsure how to spend the money. What might be the most appropriate purchase for Amanda?
A device that checks blood glucose and pairs with an app that evaluates sugar intake per meal
An activity tracking tool that pairs with an app to calculate calorie intake and calories burned
An app that features menu planning with healthy recipes and pairs with a calorie tracking tool
An exercise video g
Answer:
B
Explanation:
Bing Bong Bing Bong
Needle size is determined by a) gauge and length. b) the size of the barrel. c) its ability to filter. d) the volume of fluid it can draw up.
Answer:
by the gauge of the needle
During which phase of the Estrous Cycle does the female become restless and exhibit signs of being in heat?
A: Diestrus
B: Estrus
C: Metestrus
D: Proestrus
Answer:
Explanation:
B
What equipment is generally used to make lyophilized medications suitable for administering to the patient
What is a health service, and how can we evaluate them?
Answer:
Definition of 'health service'
1. a service that provides medical treatment and care to the public or to a particular group. the cost-effective delivery of health services to remote areas.
Explanation:
Health care evaluation is the critical assessment, through rigorous processes, of an aspect of healthcare to assess whether it fulfils its objectives. Aspects of healthcare which can be assessed include: Effectiveness – the benefits of healthcare measured by improvements in health.
Which statement BEST describes antibiotic resistance?
Antibiotic resistance occurs when the body builds up a resistance to antibiotics.
Antibiotic resistance can occur when bacteria are exposed to an antibiotic.
Antibiotic resistance occurs when antibiotics are not used.
Antibiotic resistance is a big problem in the United States, but not the world.
I would say "when bacteria are exposed to an antibiotic" but just so you know, it has to be exposed several times before it developes resistance.
what is environmental pollution
Answer:
Environmental pollution is the result of human activity and development that occurs when physical, biological and chemical agents are released to the environment in such quantities that the pollution adversely affects human health and damages the environment.
Answer:
environmental pollution may be defined as any undesirable change in physical, chemical,and biological properties of air, water and soil..
Which micronutrients are important components of bones and teeth
Answer:
Staying Healthy
The health and strength of our bones rely on a balanced diet and a steady stream of nutrients — most importantly, calcium and Vitamin D. Calcium is a mineral that people need to build and maintain strong bones and teeth.
Explanation:
HOPE THIS HELPS!!
MERRY CHRISTMAS AND HAPPY NEW 2022 YEAR!!! GOD BLESS YOU!!
Answer:
The health and strength of our bones rely on a balanced diet and a steady stream of nutrients — most importantly, calcium and Vitamin D. Calcium is a mineral that people need to build and maintain strong bones and teeth.
Explanation: I guess i was a bit late ^^
Different people are motivated in different ways true or false
It is VERY VERY TRUE .........
One of our most important resources is
People
lumber.
coal
water
I was gonna put water
Answer:
yes it is water
Explanation:
we need water for everything, and lumber, coal only for certain things, people... meh...
In swine reproduction, how many females can a yearling boar service?
A: 10
B: 15
C: 20
D: 25