Reimbursement and Auditing in Healthcare

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

How do insurance companies use documentation by the health care team?

  • To set standards for nursing practice
  • To determine payment or reimbursement for health care services (correct)
  • To determine the quality of care provided only
  • To determine the severity of illnesses only

What is one of the purposes of hospitals establishing quality improvement programs?

  • To conduct reviews of patient care and inform nurses of standards of nursing practice (correct)
  • To enforce accreditation requirements
  • To evaluate patient satisfaction only
  • To determine patient care costs

For what purpose do researchers use patient records?

  • To gather statistical data on health problems, interventions, outcomes, and deaths (correct)
  • To assess nursing staff performance
  • For billing and coding purposes only
  • To maintain hospital accreditation

What contribution does data analysis from patient records make to nursing practice according to the text?

<p>It contributes to evidence-based nursing practice and quality health care (C)</p> Signup and view all the answers

What is one way to learn about an individual's response to an illness, according to the text?

<p>By reading a patient care record (B)</p> Signup and view all the answers

What is a key aspect that accrediting agencies require in patient records?

<p>An individualized plan of care developed with a patient's input (C)</p> Signup and view all the answers

In the context of reimbursement, what determines the amount hospitals receive from PHILHEALTH?

<p>Severity of illness (D)</p> Signup and view all the answers

What role do nurses play in maintaining excellence in nursing care according to the text?

<p>Conducting ongoing reviews of patient care (D)</p> Signup and view all the answers

What type of statistical data do researchers gather using patient records?

<p>Data on the incidence and prevalence of health problems and outcomes in recovery from illness (B)</p> Signup and view all the answers

Besides conducting reviews of patient care, what is another purpose of quality improvement programs established by hospitals?

<p>Keeping nurses informed of standards of nursing practice (C)</p> Signup and view all the answers

Flashcards are hidden until you start studying

More Like This

Medical Expense Insurance Flashcards
19 questions
SGQuiz
75 questions

SGQuiz

UnmatchedPluto5846 avatar
UnmatchedPluto5846
Use Quizgecko on...
Browser
Browser