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Questions and Answers
A physical therapist assistant notices a colleague consistently scheduling patients for unnecessary follow-up appointments. According to Principle 8C, what is the PTA's most appropriate course of action?
A physical therapist assistant notices a colleague consistently scheduling patients for unnecessary follow-up appointments. According to Principle 8C, what is the PTA's most appropriate course of action?
- Ignore the situation, as it is the physical therapist's responsibility to manage patient schedules.
- Report the colleague to the insurance company for potential fraud.
- Inform patients that the follow-up appointments are likely unnecessary and suggest they cancel.
- Discuss concerns directly with the colleague and collaborate to modify the schedule to align with appropriate service utilization. (correct)
Which scenario best illustrates how the Affordable Care Act (ACA) aims to make healthcare more affordable for individuals?
Which scenario best illustrates how the Affordable Care Act (ACA) aims to make healthcare more affordable for individuals?
- A large employer offering comprehensive health insurance plans to all employees without cost-sharing requirements.
- A person with an income at 200% of the federal poverty level receiving government subsidies to help pay for their health insurance premiums. (correct)
- A state government increasing funding for public hospitals to expand access to medical services.
- A hospital system implementing a new electronic health record system to streamline administrative processes.
An individual is hesitant to seek medical care due to concerns about potential financial burden. How does health insurance primarily address this concern?
An individual is hesitant to seek medical care due to concerns about potential financial burden. How does health insurance primarily address this concern?
- By directly increasing the overall cost of healthcare services.
- By sharing the risk of financial loss due to medical events across a larger pool of individuals. (correct)
- By guaranteeing that all medical treatments will be completely free of charge.
- By eliminating the need for preventive care and routine check-ups.
What is the key distinction between health insurance and other forms of insurance, such as auto or property insurance?
What is the key distinction between health insurance and other forms of insurance, such as auto or property insurance?
A military veteran receives healthcare services at a local Veterans Affairs (VA) hospital. Under which category of health insurance does this fall?
A military veteran receives healthcare services at a local Veterans Affairs (VA) hospital. Under which category of health insurance does this fall?
Flashcards
PTA's role as stewards
PTA's role as stewards
PTAs should help prevent under or over utilization of resources.
Goals of the ACA
Goals of the ACA
To make healthcare more affordable, expand Medicaid, and support innovative care models.
Why is health insurance important?
Why is health insurance important?
It ensures access to preventive care, protects against financial losses, and improves overall health outcomes.
What is insurance?
What is insurance?
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Examples of Public Insurance
Examples of Public Insurance
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Study Notes
- Physical therapist assistants must responsibly manage healthcare resources.
- PTAs should collaborate with physical therapists to avoid over or underutilizing services.
- Ensuring efficient and appropriate care delivery is an ethical obligation.
ACA Goals
- Make healthcare more affordable providing subsidies for those within 100%-400% of the federal poverty level.
- Expand Medicaid, which covers adults with incomes below 138% of the FPL, though not all states have expanded this coverage.
- Support innovative care models to reduce costs and improve efficiency.
Importance of Health Insurance
- It ensures access to preventive care and necessary medical treatment.
- Offers protection against significant financial losses.
- It enhances overall health outcomes by ensuring consistent healthcare access.
Definition of Insurance
- A financial tool used to share the risk of financial loss from adverse events.
Key Players
- Patient (Beneficiary): The individual receiving healthcare services.
- Provider (Therapist/Doctor): The entity that delivers care and services.
- Insurer (Payer): The organization that covers or reimburses medical expenses.
Differences
- Health insurance covers medical events, unlike other insurances that cover property or accident-related damages.
- It utilizes cost-sharing features like deductibles, copayments, and coinsurance.
Public Insurance
- Government-funded programs such as Medicare, Medicaid, VA, and Tricare
Private Insurance
- Employer-sponsored plans
- Direct-purchase plans
- Managed care organizations, including PPOs and HMOs
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Description
Physical therapist assistants must responsibly manage healthcare resources and collaborate with physical therapists to avoid over or underutilizing services. Ensuring efficient and appropriate care delivery is an ethical obligation. Health insurance ensures access to care, offers financial protection and enhances health outcomes.
