Providers in capitated managed care plans who are paid flat monthly fees must still file claims with the ___ payer, since the payer uses the claim data to assess utilization
Answers
Providers in capitated managed care plans who are paid flat monthly fees must still file claims with the primary payer, since the payer uses the claim data to assess utilization.Providers in capitated managed care plans who are paid flat monthly fees must still file claims with the primary payer, as the payer uses the claim data to assess utilization and determine medical necessity.
Explanation: Capitated managed care plans are those where healthcare providers are paid a flat monthly fee per patient enrolled in the plan, regardless of how many healthcare services are provided. This form of payment structure is in contrast to a fee-for-service model in which the healthcare provider is paid based on the number of services they provide. Even though capitated managed care plans are simpler in structure, providers who participate in these plans must still file claims with the primary payer. This is because the primary payer uses the claim data to assess utilization and adjust the capitation rates.
Capitated managed care plans provide financial incentives for providers to deliver appropriate healthcare services efficiently. The payer provides a fixed payment to the provider regardless of the amount of healthcare services rendered. However, providers must still file claims with the primary payer so that the payer can track the utilization of healthcare services and adjust capitation rates accordingly. In this sense, the provider is not relieved of the administrative burden associated with filing claims. Instead, the provider still has to document the healthcare services provided to each patient and submit that documentation to the primary payer, but payment is determined based on the capitation rate rather than a fee-for-service
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Related Questions
this shows a lender, if you have a good track record of paying debts. A. loan B.profit planning C. SBA D. credit rating
Answers
Answer:
The big three C's – Credit, Capacity, and Collateral – are really the drivers how lenders determine who gets a loan, how much they'll loan, and what the interest charge will be.Jonathan is a photographer. He has been hired by a company to shoot an advertisement for their product. Which role does Jonathan play in the advertising process for the product? Jonathan plays the role of a in the advertising process for the product.
Answers
Jonathan is a photographer. He has been hired by a company to shoot an advertisement for their product. Jonathan plays the role of a consultant in the advertising process for the product.
What is a consultant?Generally, A professional who, in addition to providing advice, engages in additional activities that serve a purpose related to their area of expertise is known as a consultant. As a kind of contingent labor, consulting services are often classified as falling within the umbrella of professional services.
Consultants, who are often known as management consultants, assist businesses in dealing with change and finding solutions to issues in order to make such businesses run more effectively and, as a result, more financially.
In order to assist their client organizations in becoming more successful in their commercial endeavors, consultants provide them with guidance and knowledge.
In conclusion, Since Jonathan was brought in from outside the organization to do a particular task, I would classify him as a contract employee, sometimes known as a consultant.
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CQ
Jonathan is a photographer. He has been hired by a company to shoot an advertisement for their product. Which role does Jonathan play in the advertising process for the product? Jonathan plays the role of a ____ in the advertising process for the product.
Disadvantages of choosing a job that is extremely popular or in demand
Answers
The disadvantage of choosing a job that is very popular or a job that is in high demand is that after a while such a job may become saturated or it would become monotonous.
What is a high demand job?This is the term that is used to refer to a job that the people that wpould employ labor are constantly in need of. Such a job is one that would require the people that have the qualification to opt in and get the places and the roles that they are to fill.
The issues that may arise from such a job that is in high demand is that after a period, such a job may have a lot of persons that would want to fulfil the role.
The number of qualified persons may become more than the job that is available for the people to do in the long run.
Hence this is a disadvantage. Therefore I would conclude by saying that the disadvantage of choosing a highly popular job is that the number of persons that are willing to fulfil the role may exceed the job overtime.
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question 3 gap analysis is used to examine and evaluate how a process currently works with the goal of getting to where you want to be in the future. 1 point
Answers
Gap analysis is a method used to assess and assess the existing processes to determine the disparity between the current state and the desired future state.
Gap analysis is a valuable tool employed to bridge the gap between the current state of a process or system and the desired future state. It involves evaluating and analyzing the existing processes, systems, or performance metrics to identify areas of improvement or misalignment. The purpose of conducting a gap analysis is to understand the discrepancies or gaps that exist between the current and desired states, and then develop strategies to address those gaps and achieve the desired outcomes.
The process of conducting a gap analysis typically involves several steps. Firstly, the desired future state or goal is clearly defined, outlining the specific objectives, targets, or performance metrics to be achieved. Then, the current state is thoroughly examined, including processes, resources, capabilities, and performance data.
This assessment helps to identify gaps or disparities between the two states. Once the gaps are identified, strategies and action plans can be formulated to bridge those gaps and move towards the desired future state. These strategies may include process improvements, resource allocation, training and development, technology implementation, or any other necessary measures.
Overall, gap analysis provides organizations with a structured approach to assess their current state, identify areas for improvement, and develop plans to close the gaps and achieve their desired future state. It helps organizations make informed decisions, allocate resources effectively, and implement changes to optimize their processes and performance. By understanding the gaps and taking appropriate actions, organizations can align their current practices with their future objectives and enhance their overall efficiency and effectiveness.
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Give an example of reframing a problem by using the ‘Clarify the Problem and Goals’
worksheet in It’s Learning. Create the worksheet in your word document, make sure to
fill it out to show that you understand how to reframe the problem.
Answers
Reframing a problem by using the ‘Clarify the Problem and Goals’ worksheet in It’s Learning involves understanding the problem and the goals associated with it. This can be done by breaking down the problem into smaller pieces and looking at it from different angles.
To illustrate this, consider the following example:
Problem: I'm feeling overwhelmed by all of my upcoming exams
Clarify the Problem and Goals Worksheet:
Creating a study scheduleUtilizing study resourcesTaking breaks while studyingPrioritizing tasksCreate an Action Plan:
By following the steps outlined in the 'Clarify the Problem and Goals' worksheet, the problem of feeling overwhelmed can be broken down into smaller and more manageable parts, making it easier to come up with a plan of action.
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Susan Sleugh earns $89,079 annually. Income tax is charged using the following information: 1.11% on on first $45225 of taxable income 2.13% on next $83989( over $ 45225 upto $129.214) 3. 15% on $129.214 Calculate the annual income tax payable.
Answers
Susan Sleugh earns $89,079 annually. Income tax is charged using the following information: 1.11% on the first $45225 of taxable income, 2.13% on the next $83989( over $ 45225 up to $129.214), and 15% on $129.214. Susan Sleugh's total tax payable is $-3526.60.
For income below $45225, the rate of tax is 1.11%. Therefore the amount of tax that Susan has to pay for the income below $45225 is:1.11/100 × 45225 = $501.28
Next, for the next $83989( over $ 45225 up to $129.214) the rate of tax is 2.13%. Therefore, the amount of tax that Susan has to pay for this amount is 2.13/100 × 83989 = $1791.27Now, for the amount above $129.214, the rate of tax is 15%.
Therefore, the amount of tax that Susan has to pay for the amount above $129.214 is:15/100 × (89079 - 129214) = -$5829.15. Hence, her total tax payable for the year is Total tax payable = $501.28 + $1791.27 - $5829.15= -$3526.60. Susan Sleugh's total tax payable is $-3526.60.
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assume that the fed announces the economy is so strong, they will increase interest rates more times in the coming year than previously announced. this means that:
Answers
If the Fed announces that it will increase interest rates more times in the coming year than previously announced, it means that they are taking a more hawkish stance toward monetary policy.
The decision to increase interest rates is usually taken by the Federal Reserve when they feel that the economy is performing well and that inflation is picking up. By raising interest rates, the Fed aims to slow down economic growth and keep inflation in check.
If the Fed announces that it will increase interest rates more times in the coming year than previously announced, it indicates that they have become more confident in the strength of the economy. They may have revised their economic projections upwards or received new data that suggests that the economy is performing better than expected.
This announcement also implies that the Fed is taking a more hawkish stance toward monetary policy. A hawkish stance means that the Fed is more concerned about inflation than economic growth and is willing to take actions, such as raising interest rates, to rein in inflation. A more hawkish Fed could lead to higher borrowing costs for consumers and businesses, which could potentially slow down economic growth.
Overall, the announcement that the Fed will increase interest rates more times in the coming year than previously announced is a signal of a stronger economy and a more hawkish monetary policy stance.
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What does ceteris paribus mean?
Answers
Answer:
rat
Explanatio
in a mixed economy who answers the three economic questions
- consumers
- the government
- producers
- both A and B
Answers
How important is money
Answers
Answer:
very important
Explanation:
money is a global income source for everyone. we all have different types but it is all still money. now say one country got rid of money and had people pay for stuff using other things. if china did that lots of different countries wouldn't be able to get stuff from there unless they had so much of that product they could just give it up.
__________ is the amount by which the predicted value differs from the observed value of the time series variable.a. Mean forecast errorb. Smoothing constantc. Mean absolute errord. Forecast error
Answers
Forecast error is the amount by which the predicted value differs from the observed value of the time series variable.
Mean forecast error is the average of all forecast errors, while mean absolute error is the average of the absolute values of all forecast errors. Smoothing constant refers to the weight given to the most recent observation in a time series forecasting method.
Mean absolute error (MAE) is a common method used to calculate forecast error. It is the average of the absolute values of the forecast errors, and it provides a measure of the average magnitude of the errors. A smaller MAE indicates a more accurate forecasting model.
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earley corporation issued perpetual preferred stock with a 12% annual dividend. the stock currently yields 8%, and its par value is $100. round your answers to the nearest cent. what is the stock's value?
Answers
The value of the perpetual preferred stock is $150. The value of the perpetual preferred stock can be calculated using the dividend discount model (DDM) formula.
The value of the perpetual preferred stock can be calculated using the dividend discount model (DDM) formula, which is V = D / R, where V is the stock's value, D is the annual dividend, and R is the required rate of return or yield.
In this case, the annual dividend is 12% of the par value, which is $100. Therefore, the annual dividend (D) is $100 * 0.12 = $12.
The stock currently yields 8%, so the required rate of return or yield (R) is 0.08.
Now, we can calculate the stock's value (V) using the DDM formula:
V = D / R
V = $12 / 0.08
V = $150
Therefore, the value of the perpetual preferred stock is $150.
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PLEASE HELP WILL MARK AS BRAINLIEST ITS URGENT
Answers
Cash is an _____.
A) asset
B) expense
C) none of the above
(question is from small business entrepreneurship A)
Answers
A. Asset
Explanation:
-asset is a useful or valuable thing
Due to the necessity of living on a fixed income, many retirees find it difficult to _______. a. Afford to keep their large homes b. Maintain their old standard of living c. Pay for unexpected expenses d. All of the above
Answers
Answer:
D:all the above
Explanation:
i took the unit test.
Answer:
Its 100% D
Explanation:
Got a 100%
monopolistically competitive firms are likely to have ______________ prices in the long run than will occur in a perfectly competitive industry producing similar goods.
Answers
Long-term prices for items produced by firms with the monopolistic competition are likely to be the same as those in perfectly competitive markets.
A monopoly is a type of imperfect competition where a seller or producer controls the majority of the market's customers due to the absence of alternatives or rivals. A monopolistic competition is a type of imperfect competition in which numerous vendors compete to capture market share by distinguishing their goods. When just one company dominates an entire industry or even a sizable portion of it, that company is considered to have a monopoly. Monopolies historically have benefited the firms who own them because they can increase costs and decrease services without repercussions.
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you are an administrative assistant in the purchasing department. Another administrative assistant is getting married in three weeks. Rumor has it that after the wedding, she will not be returning, and two of your peers have come to you asking if it is true because they want to apply for her job. you have not seen an official announcement, however, the assistant did tell you that she plans not to come back. What should you say to your two coworkers?
Answers
In this situation, You should tell your coworkers that you are unsure and that it is not yet official announced.
Co - workers.
Co workers refers a person with whom one works, typically someone in a similar role or at a similar level within an organization.
Given,
Here we have given that, you are an administrative assistant in the purchasing department. And another administrative assistant is getting married in three weeks. There is a rumor has it that after the wedding, she will not be returning, and two of your peers have come to you asking if it is true because they want to apply for her job. Now, you have not seen an official announcement, however, the assistant did tell you that she plans not to come back.
Here we need to find how you should handle this situation.
While we looking into the given question, we have identified the following,
There are 2 administrative assistant in your company.
One is you and another one is a girl and she get married in three weeks. And she also planned to resign after her marriage but this resignation is not officially confirmed.
So, in this situation, two of your peer interested for the position and asking you about the recruitment process.
Here you have to reply the co workers that the resignation is not conformed and if it is officially announced they you have the option to apply for that position.
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During the month of march, john invested $19,000 in starting his landscaping business. the journal entry would be:_________
Answers
The journal entry for John's investment of $19,000 in his landscaping business during the month of March would be as follows:
1. Debit: Cash - $19,000
Credit: Owner's Equity (or Capital) - $19,000
Explanation:
- The first part of the journal entry is the debit side, where we record the increase in cash due to John's investment. The cash account is debited with $19,000 because John invested this amount in his business.
- The second part of the journal entry is the credit side, where we record the increase in owner's equity or capital. In this case, the owner's equity account is credited with $19,000 to reflect the increase in John's investment in his business.
By debiting the cash account, we are showing that the business received $19,000 in cash. By crediting the owner's equity account, we are showing that the owner's investment in the business has increased by $19,000. This journal entry captures the initial investment made by John to start his landscaping business.
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a daily snapshot of key performance indicators and operating statistics is called lagging indicators. group of answer choices true false
Answers
A daily snapshot of key performance indicators and operating statistics is called lagging indicators is a false statement.
What is operating statistics?
A set of data known as "operational statistics" describes the activities of a company, organization, or agency. Additionally, networking, institution, or tight control may be affected.
In order to constantly enhance strategic quality and effectiveness, a ratio analysis (BSC) is a managing product that includes evaluation on both company's internal procedures and external outcomes.
A daily snapshot of key performance indicators and operating statistics is called Balanced Scorecard and not the lagging indicators.
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A certified financial advisor, who works for an accredited nonprofit specializing in
helping consumers repay debt in a responsible manner through education,
budgeting, and other tools
Answers
Answer:
credit counselor
Explanation:
A credit counselor is a certified professional whose work entails guiding clients to repay off their debts. A credit counselor is an expert in money management, personal budgeting, and debt control. He or she helps a client develop a debt repayment plan and may negotiate lower interest rates with creditors.
A credit counselor works in a non-profit making organization that offers credit counseling services. They offer advice on finance and money management and educates clients on their preparing personal budget
How to calculate momentum?
Answers
Answer:
p=mv
Explanation:
the formula for momentum is
p=mv
Answer:
By multiplying mass and velocity
Explanation:
market-based forecasting of exchange rates has shown to be more consistent and reliable than the other primary forecasting methods. true false
Answers
The following statement, "Market-based forecasting of exchange rates has shown to be more consistent and reliable than the other primary forecasting methods" is True.
Market-based forecasting is a type of forecasting that uses market data to predict future market trends. This method can be used to forecast demand for a product or service, as well as exchange rates.
Market-based forecasting is often used by businesses to make decisions about production, pricing, and marketing. This method can be useful for short-term forecasting, but it can also be used to predict long-term trends.
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Which person appears to be polychronistic?
Ali invited a fellow classmate, Shari, to dinner. She arrived at the restaurant at precisely 7:00p.m., the agreed time. Ali arrived a half-hour later and explained that he had to wrap up a 7:00p.m. appointment with his professor.
A.Shari
B.Ali
Answers
Answer:
Ali is polychronistic because he didnt arrive on time.
shari belongs to monochronic culture because she values time.
Explanation:
PLEASE HELP ME!!!!
Agricultural managers need to
possess which of the following
skills?
A. The ability to start a business from scratch.
B. Understanding of the different kinds of
economies in the world.
C. Vast knowledge of equipment, shipping and
storage of products.
D. A masters degree in business administration.
Answers
Answer:
C. Vast knowledge of equipment, shipping andstorage of products.Explanation:
the other answer is wrong, i j did this in my acellus
Suppose the fed announces that it is lowering its target interest rate by 75 basis points, or 0. 75 percentage point. To do this, the fed will use open-market operations to the money by the public.
Answers
When the Fed increases the volume of money in circulation or the money supply to the public interest rate is bound to reduce.
What is Money Supply?In Economics, money supply is defined as the capacity of cash in the position of people in the society in any point in time. In other word, it the volume of money in circulation.
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in the appraisal process, the capitalization rate is used by an appraiser to determine which type of value?
Answers
Present value of an income-producing property.
What kind of value?The present worth of an income-generating property. The capitalization formula calculates the present value of an income-producing property using current net operating income (NOI). The income approach is a real estate valuation method that estimates fair value based on the revenue generated by the property. It is determined by dividing net operating income by capitalization rate.
The income approach encompasses any means of transforming a revenue stream into a market value indication. The income technique is also known as the capitalization approach since capitalization is the act of transforming predicted income into a market value indication.
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An investor is looking at two properties, but will only purchase one of them. Each is similar in utility and location, and has an annual net operating income of $20,000. One has a listing price of $220,000, while the other is listed at $200,000. The investor purchases the $200,000 property. Which economic principle is demonstrated in this example?
A. Regression
B. Externalities
C. Substitution
D. Contribution
Answers
Answer:
contribution would be the answer :)
Explanation:
I will give the right answer brainliest. Choose the option that best matches the description given.
_____ try to influence legislation and help human services organizations to achieve their goals.
1. Legislative aides
2. Lobbyists
3. Lawyers
Answers
Answer:
2. Lobbyists
Explanation:
A lobbyist is any individual or a group of individuals who communicates directly or indirectly with others to influence or attempt to influence the drafting, debate, vote, approval, or introduction of some legislation. In this context, a lobbyist may be a legislator trying to influence fellow legislators or any person who communicates with a legislator to advocate and promote the desires of human services organizations.
Answer:
Lobbyists
Explanation:
How does the federal reserve slow inflation and economic growth
Answers
Answer:
At such high inflation rates, the economy tends to break down. ... When inflation is too high, the Federal Reserve typically raises interest rates to slow the economy and bring inflation down. When inflation is too low, the Federal Reserve typically lowers interest rates to stimulate the economy and move inflation higher.
Explanation:
Plz mark brainliest thanks
PLZ HELP ME!!!!!!
Which statement about credit card interest rates is TRUE?
A.) The more money you spend on purchases, the higher your interest rate will be
B.) A high interest rate means you'll pay MORE money total
C.) A high interst rate means you'll pay LESS money total
D.) Most credit cards do not charge any interest rate
Answers
Answer:
I think its A?
Explanation: