health insrance redo already claimed

Directions: Answer each of the following questions. Your responses should be 3-5 sentences in length for each question.

1. Identify the three types of HMOs and how they differ in delivery of healthcare services.

2. What are the two types of foundations for medical care (FMCs), and how do they work?

3. What are the five categories of patients covered under Medicare?

4. What impact does the Tax Reform Act have on Medicare billing?

5. Identify the two classifications of needy and low-income individuals who may be eligible to receive Medicaid benefits.

6. What special practices and procedures should the medical office use when accepting a Medicaid patient?

Critical thinking

1-2 paragraphs each

1. Lucy, a 22-year-old, just entered the workforce and must choose a healthcare plan offered through her new company. She says she is daunted not only by the variety of managed care plan options, but by all the acronyms associated with those options. She asks you what the main differences are among IPAs, PPOs, and POSs.

2. Describe at least three aspects of managed care organizations’ structure or administration that are designed to contain costs while delivering healthcare services to subscribers. How do these issues affect the medical office?

3. What has been the impact of Medicare on the healthcare system?

4. What are some of the pros and cons for a physician becoming a participating physician (par) in Medicare?

5. How are Medicaid claims processed?

WILL BE ATTACHING ANOTHER DOCUMENT

Each question should have a 2 to 3 paragraph response. Remember to support your work with APA references and in-text citations. Please visit the Academic Resource Center for concise APA guidelines.

Orszag, P. R. (2011). How health care can save or sink America: The case for reform and fiscal sustainability. Foreign Affairs, 90(4), 42-56. Retrieved from http://search.proquest.com/docview/873487197?accountid=141600

1. After reviewing the LIRN article, “How Health Care Can Save or Sink America: The Case for Reform and Fiscal Sustainability,” respond to the following:

a. There are essentially four conceptual approaches to constraining the rise in health care costs. Choose two of the four approaches and expand on each strategy.

b. Health care legislation includes three basic categories of measures aimed at containing costs. Choose one of the three cost containing categories and expand on the measure aimed at cutting costs.

c. Click on the following link to read the blog, “Vic Fuchs Speaks!” The economist Victor Fuchs has underscored the necessity for changes in the health care system in three areas: information, infrastructure, and incentives. After reading the blog, describe Fuchs’ formula for how to get physicians to practice cost effective medicine.

(HERE IS THE LINK FOR THE BLOG)

http://thehealthcareblog.com/blog/2010/09/19/vic-fuchs-speaks/

2. After reviewing the Kaiser Foundation video, “The Story of Medicare: A Timeline,” respond to the following:

a. Explain why Medicare is important.

b. Describe the “donut-hole” and explain how and why this aspect of Medicare Part-D has changed.

c. How does Medicare impact the elderly and disabled Americans that it serves today, and what is one challenge that must be addressed to ensure its long-term sustainability?

(LINK TO VIDEO)

https://www.youtube.com/watch?v=693XQSujAh8&feature=youtu.be

3. After reviewing the Kaiser Foundation video, “Health Reform Hits Main Street,” respond to the following:

a. Describe at least three “requirements” that have been established in patient care under the ACA.

b. Describe three areas of care under the ACA that are “prohibited” by the law.

c. What diverse groups of individuals that are residing in the United States are currently unable to receive care under the ACA? Provide one solution to ensure that these groups of individuals could/should receive care regardless of their citizenship status.

(link to video)

https://www.youtube.com/watch?v=vmdbllWOOzs