which form of managed care restricts providers to caring for individuals who are memebers of theri organization?

Answers

Answer 1

Answer: Health Maintenance Organization (HMO)

Explanation:

The answer is Health Maintenance Organization (HMO) which is in contrast with Preferred Provider Organization (PPO), Point of Service Plan (POS), and Exchange Provider Organization (EPO).

This type of managed care restricts providers to caring for individuals within its organization.

Health Maintenance Organization provide a wide range of comprehensive health care services for the benefits of its members usually in exchange for a fixed periodic payment which could be monthly or even annually depending on the prearrangement.

In this type of managed care, the Health maintenance Organization coordinates all the basic health care of their members.

Answer 2

Answer:

Health maintenance organization (HMO)

Explanation:

A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or annual fee. An HMO is made up of a group of medical insurance providers that limit coverage to medical care provided through doctors and other providers who are under contract to the HMO.


Related Questions

20 points! will mark brainliest

write in your own words
List and describe the components of exercise prescription such as overload principle, type, progression, or specificity.

Answers

Answer:

Only particular workouts can improve the goals you are aiming for.

Explanation:

1. A 43-year-old man has had a cough and fever for the past 2 months.. A transbronchial lung biopsy is performed, yielding a specimen with the microscopic appearance shows granulomas. Which of the following chemical mediators is most important in the pathogenesis of this lesion? A Bradykinin B Complement C5a C Interferon-v D Nitric oxideE Prostaglandins 34 2. An 8-year-old girl has had difficulty swallowing for the past day. On examination, her pharynx is swollen and erythematous with an overlying yellow exudate. Laboratory studies show neutrophilia. Streptococcus pyogenes (group A streptococcus) is cultured from her pharynx. Which of the following substances is most likely to increase in response to pyrogens released by this organism? A Hageman factor B Immunoglobulin E C Interleukin-12 (IL-12) D Nitric oxide E Prostaglandins 3. A 41 -year-old man has had a severe headache for the past 2 days. On examination, his temperature is 39.2 0 lumbar puncture is performed, and the cerebrospinal fluid obtained has a WBC count of 910/ mm3 with 94% neutrophils and 6% lymphocytes. Which of the following substances is the most likely mediator for the fever observed in this man? A Bradykinin B Histamine C Leukotriene B4 D Nitric oxide TNF

Answers

Answer:

1. (B) Interferen-V  

2.(E)

3.(E)

Explanation:

1.Interferon-V is the most important in the pathogenesis of this lesion because, it promotes the formation of epithelioid cells and giant cells.

2.Immunoglobulin will be increased in response to inflammatory responses with allergins and with invasive parasites.

3.The most likely mediator for the fever is interleukin-1 ( IL-1) and tumor necrosis factor, TNF, which are produced by macrophages and other cell types.

What makes a crisis access hospital (CAH) different from an intensive care unit (ICU)?

Answers

Answer:

A crisis access hospital provides temporary care while an intensive care unit provides care for a non-limited time.

Explanation:

A crisis access hospital (CAH) provides approximately 96 hours of care, while an intensive care unit (ICU) provides intensive care for a non-limited time. The professionals in the ICU are highly trained, and their patients would not live without their close monitoring and life support machines.

An Rh-negative mother who gave birth at 10:30 AM on January 7 should receive her Rh immune globulin injection no later than when?

Answers

Answer: Before 10:30am January 10th

Explanation:

When a Rhesus negative mother gives birth to a rhesus positive child, it is expected that she gets a shot of rhesus immune globulin within 72 hours postpartum but when this is known during during pregnancy it is expected that the injection is given around 26-28 weeks gestation however it can be given postpartum not later than 72 hrs after birth.

So for this woman who gave birth at 10:30 am January 7th, assuming she was not given a shot of Rhesus immune globulin at 26-28 weeks gestation, she should be given the shot before 10:30am January 10th

An important source of energy for muscles during times of rest and low-intensity exercise is a. protein. b. vitamins. c. fat. d. water.

Answers

Answer:The correct answer is c. fat

Explanation:

During rest and at times of normal activities that is low intensity exercise, fats provide 80 - 90% of energy, carbohydrates provide 5 - 18% and protiens provide 2 - 5%.

Which of the following are basic tendencies in personality and which are characteristic adaptations?

Answers

Answer:

Biological bases

Explanation:

The biological basis of personality is the collection of brain systems and mechanisms that underlie human personality.

_____ is considered a sign of mental health _____ when people are terminally ill. Fear of death; for all age groups Acceptance of death; in late adulthood Acceptance of death; for all age groups Fear of death; in adolescence

Answers

Answer:

Acceptance of death; in late adulthood

Explanation:

The late adulthood of people gives them the acceptance of death because they might as well not consider "wasting anything else".

A terminal illness refers to an incurable or predicting to a death illness such as cancer.

Not all age could accept death. Fear of death can apply for all age but not in terms of terminal illness.

Answer:

Acceptance of death is considered a sign of mental health in late adulthood when people are terminally ill.

What is the immediate progression of an alternating-arm ball dumbbell chest press?

Answers

Answer:

Alternating-arm ball dumbbell chest press.

Explanation:

Which term defines a policy that refuses to exceptions for anyone for any reason? neighborhood watch locker search zero tolerance youth court

Answers

The correct answer is C; Zero tolerance.

Further Explanation:

Schools now have a zero tolerance policy that refuses to have exceptions for anyone for any reason. There have been kindergarten students who made gestures with their hands mimicking a gun and were expelled from school.

Studies have shown that the zero tolerance policy has helped to reduce incidents in schools all over the United States. This helps to keep the other children disciplined and better behaved.

Schools may implement several disciplinary actions against students who break the zero tolerance policy such as;

expulsion for entire school yearremoved from the school districtexpelled for up to 6 weeks

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Answer:

answer is : zero tolerance

Explanation:

Maximizing reimbursement is not permitted because it involves selecting and reporting as principal diagnosis the code that results in the highest level of reimbursement for the facility, whether that diagnosis meets the criteria for selection or not. One aspect of maximizing reimbursement involves

Answers

Answer:

One aspect of maximizing reinbursement involves when a patient is admitted as an inpatient at a hospital for the treatment of urosepsis, which is urinary tract infection, UTI. A secondary code has to be assigned to indicate the cause of the infection such as E. coli

Explanation:

Then, the DRG reinbursement rate is approximately $2,300. When an encoder and DRG software grouper are used, the coder may notice that the code for sepsis results in the higher DRG rate of approximately $6, 400. If the code for sepsis is reported as the principal diagnosis, this case would most likely be reviewed by the MAC or the quality improvement organization to verify the accuracy of the reported code.

Final answer:

The discussion focuses on the ethical considerations of coding for reimbursement in health care facilities and contrasts fee-for-service systems with HMOs, addressing the concept of adverse selection in insurance markets and the impact of value-based reimbursement models.

Explanation:

The subject in question pertains to the ethics and practices in coding diagnoses for maximizing reimbursement within health care facilities. In a fee-for-service system, health care providers are reimbursed based on the services performed, but in health maintenance organizations (HMOs), the reimbursement is based on the number of patients. Adverse selection impacts insurance markets by creating a scenario where buyers who are aware of their low risk avoid insurance due to high cost, and high-risk buyers are attracted to it because of perceived benefits. This creates a financial risk for insurance companies. Value-based reimbursement models, such as those used by Medicare, encourage quality care by financially rewarding positive patient outcomes and penalizing hospitals for preventable conditions that occur under their care.

Which of the following is NOT a function of water in the body? a. helps to regulate nervous impulses and muscle contraction b. helps to transport nutrients and oxygen c.helps to excrete waste products d. provides a source of energy to work and play

Answers

Answer:

D. Provides a source of energy to work and play

Explanation:

Water does not provide a source of energy to work and play

While conventional wisdom attributes good health and longevity to good nutrition, exercise, sleep, proper sanitation, and avoiding smoking, medical anthropologists consider many other factors when looking at health. One critical aspect of health that is often overlooked is that of

Answers

Answer:

inequality

hope it helps:)

A person experiencing dizziness after using a strong household cleaner is showing:

Answers

Answer: c.) an acute effect

Explanation:

An acute effect is a kind of physiological reaction in human or animal body whose effects remain for short period of time. This can be seen in situations of exposure to chemical or toxic substances.

Household cleaner may include chemical agents which can cause irritation, dizziness and congestion to the respiratory passage. These materials can be toxic to the nasal passage. The symptoms of exposure to household cleaner are temporary this is an example of acute effect.

The prior medical conditions for which the applicant has received, or should have received, medical advice or treatment within a specified period before the effective date of a policy are called:_______

Answers

Answer:

The answer is "pre-existing conditions."

Explanation:

A pre-existing condition is a health condition or illness that existed before someone enters into an agreement or a contract, such as life insurance.

For life insurance companies, it is essential to know a person's pre-existing conditions because they do not wish to provide the coverage for such conditions. As you probably know, it is common that life insurance companies do not provide insurance to people who are terminally ill or about to die. This is the reason why they ask you to provide all necessary medical examinations before entering into the agreement.

However, once the specified period for the pre-existing condition's treatment has elapsed, the insurance company will have to cover the treatment.

After several failed attempts at treating major depressive episodes over the years, Patrick contemplates undergoing ECT. He discusses this with his doctor, who warns him that ECT can lead to _____, which can last for at least 6 months after the procedure is completed.

Answers

Answer:

Memory loss

Explanation:

ECT (electroconvulsive therapy) is a medical treatment for people suffering from mental illnesses such as depression or bipolar. The therapy involves the neural stimulation through electrical shocks. This is done while a patient is under anesthesia, and this is used as a "last resort" treatment because of the many things that could go wrong.

A dangerous symptom that can arise from this treatment is memory loss.

Our memories are basically a sequence of certain neural impulses, such as seeing something, is converted to a neural impulse by the eye, so that it can be interpreted by the brain. Any foreign electrical impulse has the potential to overwrite those memories.

The neurotransmission system of the human body is a communication network composed of what?
A) Synapses
B) Neurotransmitters
C) Receptors
D) Antigens
E) Complexes

Answers

Answer:

A) Synapses (although B. neurotransmitters and C. receptors are included in this neurotransmission system).

Explanation:

   For neurons to send messages throughout the body, they need to communicate with each other to transmit signals. However, neurons are not simply connected to each other. At the end of each neuron is a small space called a synapse, and to communicate with the next cell, the signal must be able to traverse that small space. This occurs through a process known as neurotransmission.

  When an electrical signal reaches the end of a neuron, it triggers the release of small sacs called vesicles that contain neurotransmitters. These sacs spill their contents into the synapse, where neurotransmitters move through space toward neighboring cells. These cells contain receptors where neurotransmitters can bind and trigger changes in cells.

  Upon release, the neurotransmitter crosses the synaptic gap and binds to the receptor site on the other neuron, stimulating or inhibiting the receptor neuron depending on what the neurotransmitter is. Neurotransmitters act as a key and the receptor site acts as a block. It takes the right key to open specific locks. If the neurotransmitter is able to function at the receptor site, it will cause changes in the recipient cell.

 

For dinner, Carol consumes 250 grams of carbohydrate, 50 grams of protein, and 30 grams of fat. In addition, Carol decides that she wants a glass of wine with her meal. If she drinks one glass of wine containing 10 grams of alcohol, how many total kilocalories does she consume in this meal? a. 340 kilocalories b. 1,540 kilocalories c. 1,806 kilocalories d. 2,820 kilocalories

Answers

Answer: 1,540 kilo calories

Explanation:

The energy that is supplied by the carbohydrates is 4 calories in one gram of carbohydrates.

The energy that is obtained by the protein is 4 calories per gram of protein. The fat provides 9 calories per gram of fat.

Alcohol provides 7 calories per gram of alcohol.

Hence, 250* 4= 1000 calories by carbohydrates, 50*4= 200 calories by protein and 30* 9= 270 calories by fat.

Alcohol = 10* 7= 70 calories by alcohol.

Total calories is 1540 kilo calories which is consumed by Carol for dinner.

Final answer:

For the meal, Carol consumes 1,000 kilocalories from carbohydrates, 200 kilocalories from protein, 270 from fat, and 70 from alcohol, totaling 1,540 kilocalories. Therefore, the correct answer is b. 1,540 kilocalories.

Explanation:

To calculate the total calories that Carol has consumed in her meal we need to know the caloric content per gram for each of the food groups. For carbohydrates and protein, it is 4 kilocalories per gram. For fat, it is 9 kilocalories per gram and for alcohol, it is 7 kilocalories per gram. Multiplying these by the amount consumed will give us: Carbohydrates: 250 grams * 4 kcal/g = 1,000 kcal. Protein: 50 grams * 4 kcal/g = 200 kcal. Fat: 30 grams * 9 kcal/g = 270 kcal. Alcohol: 10 grams * 7 kcal/g = 70 kcal. Adding all these gives us the total kilocalories consumed, which is 1,000 + 200 + 270 + 70 = 1,540 kilocalories. Therefore, the correct answer is b. 1,540 kilocalories.

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The nursing instructor is teaching a student about the drugs used for Alzheimer's disease. Even though cholinesterase inhibitors do not cure the disease, the instructor informs the student that they do help to slow the progression. The instructor then asks the student, "When a drug is stopped due to side effects, what happens to the client?" The student's best response would be:A. The client loses any benefit they have received from the drug.B. The client will show no changes.C. The side effects will worsen.D. The client will deteriorate at a faster rate.

Answers

d. the client will deteriorate at a faster rate. however c may be correct, depending on the drug. but it is d.

Which hormone initiates the preparation of the endometrium of the uterus for pregnancy?

Answers

Answer:

Progesterone

Explanation:

Progesterone is sometimes called the “hormone of pregnancy” and has many roles relating to fetal development. It converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time, it affects the vaginal epithelium and cervical mucus, making them thick and impenetrable to sperm.

A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point?A. Revise the education plan that has guided education.B. Explore alternatives to prosthesis.C. Refer the client to outside sources of information.D. Scale back the scope and detail of client education.

Answers

Answer:

A.

Explanation:

Revise the education plan that has guided education.

Marta is 22 years of age and weighs 132 pounds. Based on her body weight, her RDA for protein is _____ grams.

Answers

Answer: 47.87 grams

Explanation:

The protein is one of the main component of the body as it helps in the main functions of the body.

The Recommended Dietary allowances for protein is around 0.8 grams of protein per kilograms of the body weight.

This amount of protein is required by the body in order to work properly. The person here is 132 pounds which means 59 kilograms and 87 grams.

Hence, the amount of protein required is 59.87*0.8 =47.87 grams of protein.

Final answer:

Based on her body weight, Marta's Recommended Dietary Allowance for protein is approximately 47.9 grams per day, calculated using the guideline of 0.8 grams of protein per kilogram of body weight.

Explanation:

The question regarding Marta, who is 22 years of age and weighs 132 pounds, revolves around calculating her Recommended Dietary Allowance (RDA) for protein. The RDA for protein in adults is generally calculated based on body weight, with the commonly accepted guideline being 0.8 grams of protein per kilogram of body weight per day.

Since Marta weighs 132 pounds, we first convert her weight to kilograms by dividing by 2.20462 (since 1 kg is approximately 2.20462 pounds), resulting in approximately 59.87 kg. Multiplying this by 0.8 grams results in an RDA of about 47.9 grams of protein per day for Marta.

Why is it a myth that muscle turns into fat when someone stops working out? A. Muscle and fat are two different kinds of tissue. B. Muscle grows with physical inactivity. C. Fat converts into muscle but not vice versa. D. Only a small amount of muscle turns into fat. Please select the best answer from the choices provided. A B C

Answers

Answer:

A or 1Muscle and fat are two different kinds of tissue.

It is a myth that muscle turns into fat when someone stops working out because muscle and fat are two different kinds of tissue. Thus, the correct option for this question is A.

What is Tissue?

Tissue may be defined as a level of organization in multicellular organisms that significantly consists of a group or layer of cells that work together to perform a specific function. This level of organization in multicellular organisms lies after the cells.

According to the context of this question, it is a type of myth among people that muscle turns into fat when someone stops working out or prevents physical activity. This basically relies on the fact that muscle and fat are the two distinctive types of tissues that gave to play specific functions within the body of living organisms.

Therefore, it is a myth that muscle turns into fat when someone stops working out because muscle and fat are two different kinds of tissue. Thus, the correct option for this question is A.

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After taking cooking lessons, Thelma bakes a cake for her friend Louise’s birthday. When Louise sees the cake, she says, "Wow, that’s so sweet. My mom always made a special cake for my birthday, and she would decorate it so elaborately." Thelma replies, "Well I’m sorry that I didn’t decorate the cake extravagantly. I guess I still have a lot to learn about cooking." Thelma’s response illustrates:

Answers

Answer:

Defensive listening.

Explanation:

Defensive listening may be defined as be defined as when the person might take the innocent comment as an attack against them. This listening might cause misunderstandings between the people.

Defensive listening can create the wrong impression by the simple comments or individuals feels it as a defensive comments. The individual might get upset or depress by taking the simple comments in the negative sense. Thelma tooks the comment as defensive listening.

Thus, the answer is defensive listening.

Guillermo feels compelled to alternate between e-mailing, updating his Twitter status, and using his smartphone to conduct work. He often feels an adrenaline rush and his muscles tense when he is notified of incoming messages or calls. Concentration feels more difficult than in the past. Guillermo's stress is likely a result of ______.

Answers

The correct answer is C; ​technological multitasking.

Further Explanation:

When a person is immersed in their smartphone or computer they can become increasingly stressed. Since the person in the above question is using his smartphone for work and personal use, he is overdoing his time on the device.

Technological multitasking has been researched by numerous universities and scientists. There have been studies that proved the brain of a person multitasking is less flexible. This hurts the person by making it difficult to retrieve any learned information.

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From a general fitness point of view, working near a_____-repetition threshold seems to improve overall performance most effectively.

Answers

Hello, your answer would be 10

Answer:

From a general fitness point of view, working near a ten, 10 repetition threshold seems to improve overall performance most effectively.

Explanation:

The nurse is performing the initial assessment of a client in the emergency department.
Which statement by the client most strongly suggests domestic violence?

Answers

Signs of domestic violence in the emergency department are: 1. Marks or wounds on the body: they are evidence of physical attacks against the victim, usually the pacients lie about their origin. 2. Hostile or violent attitude towards health personnel: it occurs because of the abuse that they are subjected to. 3. Sense of guilt: during the interrogation they are usually blamed for the facts that involve the violent act. 4. Low weight: loss of appetite of the victim or deprivation of food by the offender. 5. Distraction: the victim focuses so much on his problem that he does not pay attention to external stimuli. 6. Costing nervousness: they lose control easily if an unexpected situation arises before them.

Which statement by the client leads the nurse to believe that the client needs additional instruction regarding the nasal decongestant?

"I will blow my nose before instilling the nasal spray."
"I will report any dizziness, drowsiness, or rapid pulse."
"I will drink 2,000 to 3,000 mL of fluid daily."
"I will use it only when I have nasal discharge."

Answers

Answer:

I will use it only when I have nasal discharge.

Explanation:

A nasal decongestant is a medication, and as such its instructions for use must be respected, since a treatment should not be abandoned before a certain number of days, nor can it fall into the overdose due to a massive use of it.

In the U.S., the largest source of funding and guidance for state and local public health programs is provided by?

Answers

Answer:

The Federal government and The State government are the largest source of funding and guidance for state and local public health programs.

Explanation:

The Federal government and The State government are the largest source of funding and guidance for state and local public health programs.

In the US, governmental public health agencies are set up to meet and solve the local public health challenges.

The Federal government of the US has the responsibility for creating laws, regulations, policies and expenditure of the resources necessary for the health and safety of the public.

The funds used in financing the health program's are gotten from levies and tax.

Which of the following is characteristic of osteoarthritis?
A. Inflammation and fibrosis develop at the joints.
B. Degeneration of articulating cartilage occurs in the large joints.
C. It progresses bilaterally through the small joints.
D. There are no changes in the bone at the affected joints.

Answers

Answer:B. Degeneration of articulating cartilage occurs in the large joints.

Explanation:

Oesteoarthritis is a disease of joint. It result due to the breakdown of underlying bone and cartilage. The symptoms involve the stiffness and pain in joint. The causes includes the injury of joint, limb development and abnormality of joint.

Answer:

B

Explanation:

This is the degeneration of articulating cartilage occuring in the joints. It is the most chronic condition of the joints.

A list that provides specific details about what a food package contains is called:________

Answers

Answer:

The correct answer is- ingredient list

Explanation:

An ingredient list provides specific details about what is present in a food package. According to the FDA, all the food ingredients should be written in decreasing order of their weight present in packaged food.

This means that the ingredient that helps in making most of the product comes first which is followed by the next ingredient and so no. If any ingredient is made up of several ingredients then that is also included in the list below the main ingredient.  

If any preservative is added then its function is described in the list. So the correct answer is the ingredient list.

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What evidence supports the cartoonists perspective about testing? The students have no expressions on their faces, showing that they are not happy about the tests. The exams are huge and are labeled "more tests" and "still more tests," showing that testing is overdone. The student's response to testing is that he is prepared for it, showing that testing works well. The children are paying attention to the test schedule, showing that students are diligent. solve the inequality for x: -3(2x+5) < -45 The human immune system can produce a specific response or a nonspecific responseto infection. Which of the Following is a specific immune response of the humanimmune system? 1. Solve for x:3(2x 1) 10 = 8 + 5xA. -7B. -3C. 19D. 21 Which correctly uses commas to set off nonessential information in the sentence? A)The press secretary a known liar swore that her words were truthful. B)The press secretary a known liar, swore that her words were truthful. C)The press secretary; a known liar, swore that her words were truthful. D)The press secretary, a known liar, swore that her words were truthful. Choose the point-slope form of the line passing through (3,5) with a slope of -3.O y -3'= -3 (ix 5)0 -3(y 5) = x - 3y - 5 = -3 (0 - 3)O 3x - 5y = -3O Describe what you look forward to most in your upcoming activities within the DCE? What can happen if a pesticide is used on an insect population but only kills 98% of insects A label control's __________ property determines whether the control automatically sizes to fit its current contents.a. Fitb. TextAlignc. MiddleCenterd. AutoSize What is the slope of the line shown below? The base of a triangle is 10 cm greater than the height. The area is 28 cm2. Find the height and thebase. The energy available to consumers determined by subtracting the energy used by plants from the total energy transformed by the process of photosynthesis. True or False Which of the following approaches emphasizes the need to follow legal rules regardless of unfavorable consequences?a. Virtue ethicsb. Utilitarianismc. Principle-basedd. Egoism A prisoner on trial for a felony is presumed innocent until proven guilty. (That is, innocent is the null hypothesis.) Which of the following represents the risk involved in making a Type II error?a. The prisoner is actually guilty and the jury sends him to jail.b. The prisoner is actually innocent and the jury sends him to jail.c. The prisoner is actually innocent and the jury sets him free.d. The prisoner is actually guilty and the jury sets him free.e. The prisoner is sent to jail. Do the new data support the hypothesis that the parasite switched surface glycoproteins once the host immune system responded to the original glycoprotein? What name is given to the rate at which velocity changes? Recent work suggests that problems with the endogenous opioid system are as-sociated with which personality disorder? As chief justice of the Supreme Court, John Marshall a. promoted the growth of state sovereignty. b. supported the attainment of political and social equality. c. emphasized the primacy of property and property rights. d. abandoned his Federalist sympathies. Which number line best shows how to solve 8 (6)? A number line from negative 10 to 10 is shown with numbers labeled at intervals of 2. An arrow is shown from point 0 to negative 8. Another arrow points from negative 8 to negative 6. A number line from negative 10 to 10 is shown with numbers labeled at intervals of 2. An arrow is shown from point 0 to negative 6. Another arrow points from negative 6 to negative 8. A number line from negative 10 to 10 is shown with numbers labeled at intervals of 2. An arrow is shown from point 0 to negative 6. Another arrow points from negative 6 to 2. A number line from negative 10 to 10 is shown with numbers labeled at intervals of 2. An arrow is shown from point 0 to negative 8. Another arrow points from negative 8 to negative 2. Linda owns 4 shares of a certain stock. Yesterday the total value of her shares went down by 32 dollars. What was the change in value for each share? Steam Workshop Downloader