NR 511 WEEK 1 QUIZ 2

Week 1: Quiz Question 1 0 / 1 pts An 81-year-old patient presents for a physical. She recently had a fall and now has problems walking up her stairs. The only restroom in the house is on the second floor. She also has a flight of stairs outside her house she has to navigate in order to reach street level, and this is difficult for her. Where does this information belong in your chart note? Plan. Review of systems. You Answered Assessment. Correct Answer Functional health problems. The patient is having trouble with her normal routine and daily life due to her recent fall, so this information belongs in the functional health patterns section. Question 2 1 / 1 pts Which one of the following is true regarding the importance of documentation? It is only important in order to bill the patient for your service. It allows you to communicate your findings with the general public. Correct! It allows you to communicate your findings to other providers and serves as a record for the visit. It is only important for defending yourself in the event of a law suit. The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family factors, positive and negative findings on physical exam and the provider's plan. Documentation is important for billing purposes, communication with other providers and in the case litigation. Question 3 1 / 1 pts Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does this mean? Correct! The HMO reimburses the provider a predetermined fee per client per month based on the client’s age and sex. The HMO is not responsible for provider reimbursement. The HMO reimburses the provider only if the patient has paid their deductible. The HMO reimburses the provider on a fee-for-service basis. The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid, comprehensive systems of health benefits that combine both financing and delivery of services to subscribers. They may pay providers on a capitated or fee-for-service basis. Question 4 1 / 1 pts What is an Accountable Care Organization (ACO)? A payment system for episodes of care to save money for the health care system. Correct! A group of providers and suppliers who come together voluntarily to give coordinated, high-quality care to Medicare patients. A bundling of pilot organizations. A risk pool that saves the overall organization money and maximizes reimbursement. ACOs are groups of doctors, hospitals and other health care providersd who come together voluntarily to give coordinated, high-quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeeds in delivering high quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program. Question 5 1 / 1 pts The phrase usual and customary refers to: Correct! How charges for a service compares with charges made to other persons receiving similar services and supplies.