Which of the following is not a method of reimbursement:

A) fee-for-service.
B) waiver of liability.
C) capitation.
D) episode-of-care.


B

Health Professions

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James Roberts is a well-known patient who returns for a postoperative follow-up 2 weeks after an abdominal exploration and splenorrhaphy

Seventeen days ago, James fell in his bathroom after stepping out of the shower and slipping on the wet tile floor, sustaining a grade 3 splenic laceration. Subsequent abdominal exploration and splenic repair was performed. Recovery has proceeded as expected, with appropriate healing of abdominal wound, no signs of infection or dehiscence; however, James is very concerned that the continued bruising that has remained on his abdomen and across his back is a symptom of a complication. Physician collects an expanded problem-focused history, performs an expanded problem-focused physical examination, and makes medical decisions of low complexity. The physician assures James that the bruising is a normal part of the healing process. The physician documents that more than half of the visit was spent in counseling the patient and his wife on postoperative care. An abdominal exploration and splenorrhaphy have a 90-day global period of surgery. Which of the following best reflects this E/M service? a. Office or other outpatient service, established patient, level 3, and modifier 32 because this service has been mandated by an outside organization b. Office or other outpatient service, established patient, level three, and modifier 24 because this service occurred during the postoperative period, and the intent of the service is unrelated to the surgery c. Office or other outpatient service, established patient, level 3, and modifier 57 because the physician decided surgery needed to occur d. No E/M service reportable because the intent of this service is related to the abdominal surgery and splenorrhaphy and is therefore part of the postoperative service

Health Professions

Treatment of a patient with second-degree burns on the front and back of both legs would include:

A) covering the burned area with dry, sterile dressing. B) stopping the burning process. C) removing clothing and jewelry. D) all of the above.

Health Professions

Answer the following statements true (T) or false (F)

1. ACOs are a group of insurance providers. 2. A managed care contract that involves payment through capitation provides incentives for physicians to emphasize preventive care. 3. Most managed care contracts allow an unlimited time frame for submitting claims. 4. Under an ACO contract physicians receive a fee for each service they perform. 5. Under an ACO the member can use any doctor or hospital that accepts Medicare.

Health Professions

Confidential information that has been told to a physician by the patient is called

A) advance directives. B) informed consent. C) privileged communication. D) self-determination.

Health Professions