Reference no: EM13764196
1. Why were the first proto-HMOs formed in America? What were the original driving factors in the HMO movement?
2. What is meant by indemnity coverage, and how does it change in managed indemnity?
3. What is the role of the executive director in a managed care organization? Could you see yourself practicing in this position at some point in your career? Why or why not?
4. What is the role of the Peer Review Committee in a managed care organization? And why is this function so crucial?
5. Describe the calculation of capitated payments. How are these rates determined in managed care organizations?
6. Describe the use of evidence-based clinical criteria in managed care. Why is this process so important in managed care today?
7. What is meant by pattern review under managed care? Why do payers conduct pattern review, and what kinds of things might they identify during such reviews?
8. Discuss some key general aspects of physician practice behavior? Include implicit messages from training, and also environmental factors, in your answer.
9. What is the purpose of hold-harmless and balance-billing clauses in managed care contracts?
10. What is typically covered under "term, suspension, and termination" of a managed care contract?
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Horizontal merger and a vertical merger
: 1. When would it make sense to use a flexible budget as compared to a forecast budget? 2. Explain the difference between a horizontal merger and a vertical merger.
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Liability of the earlier parties for the payment
: Will issued a $2,500 promissory note made payable to himself by signing Kay's name. Describe in detail the liability of the earlier parties for the payment of the $2700 claim by Roth
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Problems based on health sciences
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An analysis of the effect of trade balance
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What is meant by indemnity coverage
: Why were the first proto-HMOs formed in America? What were the original driving factors in the HMO movement? What is meant by indemnity coverage, and how does it change in managed indemnity?
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Different it systems
: identify five different IT systems that have affected business in the past few years (i.e., business software applications, networks, hardware, internet-based technologies, databases). For each system, briefly note the following:
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Discuss the establishment clause
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Improve services by using database management systems
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Where you examine your options and defend your position
: You are a judge who believes that individuals should be allowed to choose when to die. Write a 2-3 page, APA style paper addressing where you examine your options and defend your position
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