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 Answeryou are more likely to have good mental and emotional health_______.
Answer:
if you actively make choices that would contribute to your overall health. By taking care of yourself through nutrition, excercise and cognitive tasks. But also by indulging from time to time and resting to recover each day. Also, by speaking and opening up to others is great for emotional health.
Select the correct answer.
How often do you need a tetanus immunization in order to maintain immunity?
ОА.
One time
OB.
Childhood immunizations only (three doses)
C.
Every two years
D.
Every 7-10 years
Reset
Next
Answer: D- Every 7-10 years
Explanation:
According to the CDC you should get a teatanus shot every 7 to 10 years in order to maintain immunity.
The nerves of the peripheral nervous system connect the central nervous system to
of
Select one:
A smooth muscle tissue
estion
B. sensory organs
C. glandular secretion
D. arterial blood pressure
What is a communicable disease?
A. One that you can get from an animal
B. One that you can get from food or water that you eat or
drink
C. One that you can get from a rusty nail
D. One that you can get from another person
Answer:
D. ONe that you can get from another person or an animal host.
Explanation:
Which of the following is a strategy to communicate your emergency plan to parents?
A.Ask them to review the plan if they have time
B.Parents do not need to know your emergency plan
C.Send a letter to parents after an emergency occurs
D.Review the emergency plan during parent orientation
Answer:
D
Explanation:
The following is a strategy to communicate your emergency plan to parents is Review the emergency plan during parent orientation.
What should a family communication plan include?Include a trouble contact title and number, an out-of-town communication name and number, a neighbourhood meeting location and any other significant information. Be sure every family associate has emergency phone numbers and a cell phone.
Thus, option "D" is correct.
To learn more about family communication click here:
https://brainly.com/question/1219489
#SPJ2
Why did the principles of beneficence and autonomy sometimes conflict with each other
Answer: the answer is c
Explanation: edge 2022
Your client receives a payment from the EGHP that may exceed the Medicare prevailing charge and or MAAC (maximum allowable actual charge), regardless of the provider's participating status, the provider may keep the full amount of the payment in this case.
How are food-contact surfaces to be handled between uses
A. Wash, rinse, and sanitize
B. Wipe down with cleaner
C. Clean and rinse
D.Wipe down with cleaner and sanitize
Answer:
B. Wipe down with cleaner
Wash, rinse, and sanitize is the correct order to be handled for food-contact surfaces, option A is correct.
Food-contact surfaces should be properly handled between uses to maintain cleanliness and prevent the spread of bacteria and contaminants. The recommended procedure involves a three-step process: washing, rinsing, and sanitizing. First, the surface should be washed with hot water and a suitable detergent to remove visible dirt, grease, and residue. After washing, the surface should be thoroughly rinsed with clean water to remove any remaining soap or detergent.
Finally, to ensure proper sanitation, the surface should be treated with an approved sanitize solution, such as a chlorine or quaternary ammonium compound, following the manufacturer's instructions. This final step kills any remaining bacteria or pathogens, making the surface safe for food contact. This comprehensive approach helps maintain hygiene and prevents cross-contamination in food preparation areas, option A is correct.
To learn more about sanitize follow the link:
https://brainly.com/question/33853132
#SPJ2
✨⭐TRUE or FALSE⭐✨
1. Drugs are not a social concern in the philippines
2. Filipino female is less prone to drug use than male
3. The decline of users may be associated with the government's intense efforts in combating drugs
4. The department of education was not included in the partnership of the actualization of the dangerous drugs board programs and projects
5. Shabu is one of the commonly used and abused drugs in the philippines
6. In "2008 National Household Survey on the Nature and Extent of drugs abuse in the philippines" conducted by dangerous drugs board revealed that there is an increasing number of drug users in the philippines
7. Drug misuse is the continuous use of a drug or substance other than their specified purpose
8. Department of Education integrate concepts of drug education program into curriculum to drumbeat awareness and advocate drug use prevention
9. Drug dependence is the state of physical and psychological dependence on drugs creating a person strong desire to take the substance
10. Random drug test is not effective in tracking drug abusers' in school
NØNSENSE/WRONG ANSWER: reported
CORRECT/SURE ANSWER: Mark brainliest and spam hearts
Answer:
1.false
2.true
3.true
4.true
5.true
6.true
7.false
8.true
9.true
10.false
Explanation:
HOPE IT HELP'S
IF IT'S WRONG CAN YOU JUST CHANGE IT:)
Following are the answers:
False (Drugs are a significant social concern in the Philippines.)False (Drug use is prevalent among both males and females in the Philippines.)True (The decline of users may be associated with the government's intense efforts in combating drugs.)False (The department of education is included in the partnership of the actualization of the dangerous drugs board programs and projects.)True (Shabu is one of the commonly used and abused drugs in the Philippines.)False (In the "2008 National Household Survey on the Nature and Extent of drugs abuse in the Philippines" conducted by dangerous drugs board revealed that there is a decreasing number of drug users in the Philippines.)True (Drug misuse is the continuous use of a drug or substance other than their specified purpose.)True (Department of Education integrate concepts of drug education program into curriculum to drumbeat awareness and advocate drug use prevention.)True (Drug dependence is the state of physical and psychological dependence on drugs creating a person strong desire to take the substance.)False (Random drug test can be effective in tracking drug abusers' in school)What is drug abuse?Drug abuse refers to the use of illegal drugs or the misuse of legal drugs in ways that can cause harm to the individual or society. It involves taking drugs in a manner that is not intended or prescribed by a doctor, such as taking more of a medication than prescribed or using a drug for a different purpose than it was intended.
Drug abuse can lead to a wide range of negative physical and mental health effects, including addiction, overdose, and even death. It can also have negative consequences for the individual's relationships, employment, and social standing.
Learn more about drug abuse, here:
https://brainly.com/question/18379880
#SPJ2
Which of the following three skills and attitudes best promote positive
wellness and self-esteem?
A. drinking large amounts of caffeine
M B. squeezing a stress ball to relax
Eh C. using rewards when goals met
D. pacing yourself to meet a deadline.
Which may increase a person's risk for joining a gang, despite location or background?
O attending a poorly performing school
O being exposed to media that glorifies crime
O having family members involved in gang activity
O having a history of a mental health disorder
Answer:
C
Explanation:
If the child is influnced at an early age that can affect them mentally to do the same activity as the parents at an older age.
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:
Russell just ended a three -year relationship he believed was leading to marriage . Which of the following should he do to cope with this failed relationship ?
Answer:
love you ❤️❤️❤️❤️❤️❤️❤️
what are the animals that destroy man
Although human beings can be attacked by many kinds of animals, man-eaters are those that have incorporated human flesh into their usual diet and actively hunt and kill humans. Most reported cases of man-eaters have involved lions, tigers, leopards, polar bears, and large crocodilians.
Answer:
It's actually an insect
Explanation:
Mosquitoes
In the beginning of the addiction cycle
The first step to addiction is trying the substance. It can be as fast as taking the first drink or smoking a cigarette. Or, people may have used drugs in the past without developing a dependency, but are now moving on to a more addictive substance.
List the basic ingredients for baking and explain their roles
Answer:
What are the basic ingredients in baking and their functions?
The Science Behind Common Baking Ingredients
Flour Provides the Recipe Foundation.
Fat Holds it All Together.
Sugar Is Sweet and Helps Tenderize.
Eggs Add Texture.
Liquids Add Leavening and Tenderness.
Salt Adds Flavor and Weight.
Leavening Agents Baking Soda and Baking Powder.
Explanation:
True or False. A tooth that is broken can present a choking hazard.
Ο Α.
True
OB.
False
Reset
Next
Answer:
true
Explanation:
this can accidentaly be swallowed
Answer:
false because it's simple
What are the 4 heart rate zones?
A.resting, working, target, recovery
B.resting, working, target,maximum
C.resting, warm up, target, recovery.
D.resting, warm up, target, maximum
Nurse Jane is preparing to interview someone with influenza. What is the MOST appropriate PPE for her to use?GlovesGownMaskN95 respirator
Given what we know about proper safety measures, we can confirm that if Nurse Jane is preparing to interview someone with influenza, she should use an N95 respirator.
What is an N95 respirator?an N95 respirator is a face mask. It is the most advanced form of face mask that is readily available to the public.This type of mask uses a series of filters, along with a charged metallic net on the inside to ensure that virtually no particles of any kind can penetrate. For these reasons, the N95 respirator offers an effective protection against highly contagious viruses such as influenzaTherefore, given that influenza is a virus that can survive suspended in the air for hours, making it very easier to become infected through breathing infected air, the most appropriate PPE for Nurse Jane to use is an N95 respirator to protect against this situation.
To learn more about influenza visit:
https://brainly.com/question/9383261?referrer=searchResults
PLEASE HELP
To this day, American heroes are some of the most well-known in all of history, and they placed enormous value on victory.
A.
True
B.
False
The statement is true that "heroes are well known in history and they placed enormous value on victory."
Who are American heroes?American heroes are those individuals that have made outstanding contributions to the success of the American nation. These people have written their names in Gold in the annals of American history.
The American heroes are well known in history and enormous value will always be placed on what they have done.
Learn more about American heroes: https://brainly.com/question/466398
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:
You have 24 quarts of brown stock. You need .75 cups to make one serving of kidney beans. How many servings can you make? Select one: a. 64 b. 128 c. 256 d. 18
Answer: b.128
Explanation:
24 quarts = 96 cups
96 cups divided by .75 equals to 128 servings
128 servings of kidney beans can be made from 0.75 cups of brown stock.
How to calculate servings?According to this question, an individual has 24 quarts of brown stock.
However, the person needs 0.75 cups to make one serving of kidney beans.
24 quarts of brown stock equals 96 cups i.e. 24 × 4 = 96
This means that 0.75 cups of brown stock can be made from 96/0.75 = 128 servings of kidney beans.
Learn more about servings at: https://brainly.com/question/26845542
#SPJ9
Which of the following are possible results of environmental tobacco smoke?
A-Lung cancer
B-reduced heart function
C-asthma and ear infections in children
D-all of the above
Answer:
all of the above
Explanation:
all can be a result of tobacco smoke
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.
Why do drug companies advertise a prescription drug to consumers?
Answer: because its designed to provide scientifically accurate information to patients so that they are better informed about their healthcare and treatment options.
Explanation:
how early diagnosis could improve health outcomes for affected babies
Answer:
Early detection of diseases may help in early intervention and treatment, which may either cure the disease or improve the outcome and quality of life of the patient. Newborn screening includes screening for metabolic and genetic conditions, for hearing and vision, and for congenital heart disease [1].
Explanation:
which sentence is true? less intelligent animal have small brains
Explanation:
write full question dude ,write full option
Lacto-ovo vegetarians would not eat __________. A. meat or dairy B. meat C. eggs or dairy D. dairy
Answer:
B. Meat
Explanation:
Lacto-ovo vegetarians are people who eat vegetables, eggs, and dairy products but do not eat meat.
Answer:
a) meat
Explanation:
vegetarians dont eat meat
6
What two regions of the body are represented in blue in the diagram below?
It’s in the pic
Answer:
D
Explanation:
Trust me bro
Answer:upper and lower extremities
Explanation: upper and lower extremities
what word means: the confidence and worth that you feel
about yourself.
Answer:
Yes.
Explanation:
Because confidence is a word.