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Questions and Answers
What is one reason large companies can obtain contracts at lower rates?
What is a characteristic of acute care hospitals regarding their pricing?
Which statement is true about surprise billing for out-of-network services?
What does the term 'Role Fidelity' imply in healthcare?
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What does a Deductible refer to in health insurance?
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How can Global Budgeting benefit healthcare coordination?
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What is required for a group of physicians to open a new facility?
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Which statement best describes antitrust laws in relation to healthcare companies?
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Which of the following is NOT typically considered a nurse-sensitive indicator?
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What is the main purpose of accountable care in healthcare?
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Study Notes
Patient Care and Costs
- Large companies can secure contracts for healthcare at lower rates, benefiting their employees.
- Acute care hospitals do not publish prices, making it difficult for patients to compare services.
- Surprise billing occurs when patients unknowingly receive out-of-network services, leading to unexpected charges post-emergency visits.
Regulatory and Safety Standards
- Nurse-sensitive indicators, including safety measures, help assess the quality of patient care.
- The Joint Commission does not inspect outpatient and inpatient services primarily for cost comparison.
- Role fidelity requires healthcare workers to adhere to their defined scopes of practice, relevant in situations like a patient requesting confidentiality.
Healthcare Coordination and Records
- Doctors rely on a patient's Electronic Health Record (EHR) to coordinate care effectively.
- High-cost insurance does not guarantee the best coverage or service quality.
Market Dynamics and Legal Framework
- Antitrust laws may fail to prevent market domination, affecting competition in the healthcare sector.
- Certain facilities struggle to remain operational despite state or federal support.
Certificate of Need (CON)
- Physicians must obtain a Certificate of Need from the state to establish new healthcare facilities.
Financial Management in Healthcare
- Global budgeting promotes care coordination and cost reduction.
- Accountability for positive health outcomes is essential for improving public health.
Patient-Centric Care
- Managing services and treatments exemplifies prioritizing patient interests.
- Patients are responsible for paying deductibles as set by their insurance companies.
Cost-Sharing Mechanisms
- Cost-sharing includes deductibles, copayments, and coinsurance, impacting overall health expenses.
Healthcare Payment Systems
- Diagnosis Related Groups (DRG) allow for extended hospital stays and additional treatments based on specific conditions.
- The Affordable Care Act (ACA) funding is derived from multiple sources to support healthcare accessibility.
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Description
Test your knowledge on healthcare billing practices and patient services. This quiz covers various topics including hospital pricing, surprise billing, and safety measures in nursing. Perfect for healthcare professionals and students looking to review essential concepts in medical billing.