Compare and contrast capitation payment, per diem payment, and fee schedules
Capitation payment: a fixed dollar amount for each covered person for providing a predetermined set of health services for a specific period of time. Health care providers are responsible for providing the care needed for each patient for whom they receive capitation. The health care provider assumes the risk for the cost and the frequency of the services provided.
Per diem payment: flat daily rate paid regardless of the type of care given to the patient; used primarily in inpatient facilities and skilled nursing facilities.
Fee schedules: flat rate per procedure, visit, or service that is negotiated between the MCO and the provider. Negotiation of rates can be based on historical data or can use the resource-based relative value scale as the base and negotiate the conversion factor (dollar amount per unit) that provides appropriate reimbursement. Another method of creating a fee schedule is for payers to base the fee on a percentage of the Medicare fee schedule.
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A) Edward R. Squibb B) William Procter, Jr. C) Daniel B. Smith D) Andrew Craigie
During a surgical procedure on a pregnant patient, the surgical technologist in the scrub role may be asked to palpate what area to detect possible contractions?
a. carotid artery b. gravid uterus c. radial artery d. xiphoid process
Tobramycin 2 mL containing 80 mg/mL is ordered. The pharmacy has 160 mg/mL tobramycin in stock. How much concentrate will you need?
1 mL 2 mL 2 ½ mL 3 ½ mL
If a child does not appear to be critically ill or injured, you should
A. spend an equal amount of time with the parents. B. professionally dismiss the parents from the room. C. allow him or her to sit on a caregiver's lap. D. begin your assessment by taking vital signs.