QUESTION 24 The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed_________in which it operates. In the Borough In the county In the state and certified with local chapters 1:15 PM

Answers

Answer 1

The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed C. In the state which it operates.

What is the first requirement for an MCO?

The first requirement for any MCO that wants to offer Medicare Advantage is to be licensed in the state in which it operates. This is because Medicare Advantage plans are regulated by the states, not by the federal government.

In addition to being licensed in the state, MCOs must also be certified by the Centers for Medicare & Medicaid Services (CMS). CMS certification ensures that MCOs meet certain standards of quality and financial stability.

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Related Questions

What steps a medical team can take to help a patient who have a
signs of trauma?

Answers

When a patient shows signs of trauma, the medical team must take immediate action to stabilize the patient and treat any injuries.

Here are some steps the medical team can take to help a patient who has signs of trauma: Assess the situation: The medical team must first assess the situation and determine the extent of the trauma. They must evaluate the patient's physical, mental, and emotional condition and gather as much information about the incident as possible. This will help them make informed decisions on how to proceed with the patient's treatment and care.

Communicate with the patient and their family: Finally, the medical team must communicate clearly and effectively with the patient and their family members throughout the treatment and recovery process. They must explain the patient's condition, the treatment plan, and any potential complications or side effects of the treatment. They must also listen to the patient and their family's concerns and answer any questions they may have.

Overall, when a patient shows signs of trauma, the medical team must act quickly and efficiently to stabilize the patient, treat any injuries, and provide emotional and psychological support to aid in their recovery.

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DISEASE CARD ASSIGNMENT
Complete a Disease card for the following
CARDIOVASCULAR DISORDERS.
Aortic stenosis
# DISEASE NAME: Aortic Stenosis
1 ETIOLOGY/RISK FACTORS 2 PATHOPHYSIOLOGY 3 SIGNS & SYMPTOMS 4 PROGRESSION & COMPLICATIONS 5 DIAGNOSTIC TESTS 6 SURGICAL INTERVENTIONS 7 PHARMACOLOGICAL MANAGEMENT 8 MEDICAL MANAGEMENT 9 NURSING INTERVENTIONS 10 NUTRITION/DIET 11 ACTIVITY 12 PATIENT-FAMILY TEACHING 13 PRIORITY NURSING DIAGNOSES

Answers

DISEASE NAME Aortic stenosis is a cardiovascular condition characterized by narrowing of the aortic valve opening. When the aortic valve is stenotic, the heart must work harder to pump blood throughout the body. Aortic stenosis can be either congenital (present at birth) or acquired due to aging, infection, or trauma.

It can also be caused by conditions such as rheumatic fever and atherosclerosis.

Aortic stenosis's pathophysiology is characterized by a buildup of calcium deposits on the aortic valve, resulting in a reduction in the valve's ability to open and close properly. This narrowing of the aortic valve opening causes the heart to work harder to pump blood throughout the body. Over time, the heart muscle can become thickened, and the heart may not function as efficiently as it should.

The signs and symptoms of aortic stenosis may vary, but they generally include chest pain, shortness of breath, fatigue, dizziness, fainting, and heart palpitations. As the disease progresses, the patient may experience heart failure, which can cause fluid buildup in the lungs, legs, and abdomen and lead to kidney damage and other complications. Diagnostic tests used to diagnose aortic stenosis include echocardiogram, electrocardiogram, and chest X-ray.

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What advantages can your identify for transmitting electronic claims? Are there any potential disadvantages as well?

Answers

Electronic claims transmission is an electronic system of sending medical claims to the insurance companies. The transmission of electronic claims is faster and efficient than the traditional method of filing insurance claims through paper claims.

Electronic claims have a faster processing time, which ensures faster payments to the providers. Electronic claims reduce the claim denial rate compared to paper claims. Electronic claims eliminate the cost of printing, mailing, and processing paper claims, thereby, reducing the overall administrative costs of healthcare providers. Electronic claims improve the accuracy of medical claims and reduce errors associated with handwritten paper claims. Additionally, electronic claims reduce the need for repetitive data entry into the system. Electronic claims also streamline the processing of medical claims by reducing the need for manual intervention.

Electronic claims require a high level of technical proficiency to complete the process, which might be challenging for some providers. The initial cost of implementing the electronic claims system might be high for smaller providers or practices. The possibility of a data breach or privacy violation is higher with electronic claims, and the safety of patients' electronic health records needs to be guaranteed. The electronic system is prone to downtime or system malfunction, which can result in delayed or lost claims. In such situations, the claim has to be re-submitted, which can lead to additional costs to the provider.

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Stanford a type of aortic dissection refers to
A. De Bakey type I
B. De Bakey I and de Bakey II
C. De Bakey III
D. De Bakey II and de Bakey III
E. De Bakey II

Answers

Stanford Type A aortic dissection refers to De Bakey Type I. Type A aortic dissection (AD) is a type of acute aortic dissection that involves the ascending aorta and frequently the aortic arch, which are the parts of the aorta closest to the heart. (option a)

An aortic dissection (AD) is a medical condition in which blood passes through a tear in the inner layer of the aorta, causing the inner and middle layers to separate (dissect). When the inner and middle layers separate, a blood-filled channel, or false lumen, is formed.

The two types of aortic dissections are Stanford Type A and Stanford Type B. Aortic dissections are generally divided into two types, Type A and Type B, based on where they occur.Type A aortic dissection occurs in the ascending aorta and may extend into the aortic arch, while type B dissection occurs in the descending aorta beyond the left subclavian artery. Stanford Type A and De Bakey Type I dissections are treated surgically and are medical emergencies.

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A nurse manager in a long-term care facility is discussing evidence-based practice staff nurses. What activities should the nurse manager identify evidence-based practice?

Answers

Evidence-based practice (EBP) involves the incorporation of current research-based evidence into clinical decision making. Evidence-based practice in nursing refers to the practice of nursing that is supported by clinical research and knowledge-based on the best evidence available.

Nurses at all levels of the organization must contribute to the practice's improvement through the incorporation of EBP, which leads to better patient outcomes.

The following are some of the activities that a nurse manager can identify for evidence-based practice staff nurses are:

1. Conducting routine staff meetings that include information regarding new evidence-based practices that have been implemented in other care settings, and updating staff members on any changes to current protocols or policies.

2. Encouraging staff nurses to participate in professional development opportunities such as conferences, seminars, and continuing education courses.

3. Providing access to relevant research studies and articles through the organization's library or online database.

4. Promoting evidence-based practice by encouraging staff to participate in quality improvement initiatives and research projects that aim to evaluate and improve care.

5. Using feedback from patient satisfaction surveys, staff surveys, and other sources to identify areas of improvement and opportunities to implement new evidence-based practices.

6. Developing policies and procedures based on the best available evidence, with input from staff members who work directly with patients.

7. Encouraging staff to conduct their research studies or quality improvement projects to improve patient care and outcomes.

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You are a nurse with Oakton Infertility Clinic and you are discussing the different possibilities for infertility diagnosis and treatment with a couple -- 45 year old David and 38 year old Anita. You ask Anita for her menstrual dates for the past 6 months and the duration of menstruation for each of her period.
Anita's answers:
Menstrual duration: 5-6 days
Time between periods: 30-34 days
Assume that Anita’s menstrual flow begins today (this lab day is day 1 of her menstrual cycle) when answering the following questions:
1. On approximately what date would Anita ovulate?
2. On what dates would Anita most likely have a successful fertilization? Hint: You need to find out what the average viability of the sperm is.
3. What would the first study to be indicated to David?

Answers

1. The menstrual cycle occurs from day 1 to day 28. The ovulation day for a female is estimated at day 14. For instance, Anita, if she has a menstrual duration of 5-6 days and a time between periods of 30-34 days, then assuming the duration to be 5 days, she'll start her next period between days 35 to 39. Therefore, her ovulation period will be between day 19 to day 23.

2. the average sperm viability is between 3 to 5 days, if Anita ovulated on day 19, the sperm would remain viable until day 24. Therefore, Anita is most likely to have successful fertilization from day 19 to day 24.

3. For infertility issues, there are several studies that may be indicated to David and the initial study recommended is semen analysis. Semen analysis is carried out to determine the quality and quantity of the sperm, including the motility and morphology.

Purpose of the menstrual cycle:

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