An insured is admitted to the hospital for surgery on a herniated disk. the insurance company monitors the treatment and progress in order to make sure that everything proceeds according to the insurer's schedule. this is called
The insurance company's practice of monitoring an insured individual's treatment to ensure it adheres to a predetermined schedule is known as utilization review or utilization management. This process helps control healthcare costs and ensures that services provided are medically necessary and cost-effective.
When an insurance company monitors the treatment and progress of an insured individual to ensure that everything proceeds according to a predetermined schedule, this is known as utilization review or utilization management. This process is implemented to control costs and manage the quality of care by reviewing the necessity, appropriateness, and efficiency of the medical services provided. It is a common practice in both fee-for-service and managed care plans, such as Health Maintenance Organizations (HMOs), to ensure that the healthcare services authorized are medically necessary and within the terms of the insurance policy.
In the case of the insured with a herniated disk, the insurance company's utilization review aims to make certain that the hospital stay, surgical procedure, and any follow-up treatments align with the best practices and cost-effectiveness standards established by the insurer. This process may involve pre-authorization of services, concurrent review during the hospital stay, and retrospective review after the services have been provided. It's a balance between providing necessary medical interventions and preventing unnecessary medical spending that could arise from a moral hazard.
During an assessment of a 78 year old woman you find her skin to be cool, moist, and pale. what would you suspect?
Darcy is sitting at her desk in her office one day when, without warning, her heart begins racing rapidly, she has a sensation of being "out of her body," and she experiences dulled vision and hearing, rapid breathing, and sweating. she thinks she is having a heart attack. nothing she is doing seems to have caused such an episode. her symptoms most resemble
Before assessing the respiratory adequacy of a semiconscious infant or child, you must:
An obsessive-compulsive person who was told that everyone was required to wear shoes at all times in the house and not to vacuum for a week would be experiencing what therapy procedures
Which communication strategies do not involve speaking? Select the three correct answers.
A. Keeping a journal
B. Using "I" messages
C. Making eye contact
D. Writing a letter
The communication strategies do not involve speaking are:
keeping a journal, making eye contact, writing a letter.
What are I messages?They are a method of communication.One can communicate thoughts and emotions regarding a certain experience or contact.It is usually done with a soft voice and a sentence that commonly begins with "I".Which forms of communication do not involve speaking?They include:
gestures, paralinguisticsKeeping a journalMaking eye contactTouchWriting a letter, etc.To learn more about communication, journal, and letter here,
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The correct communication strategies that do not involve speaking are [ option a ] keeping a journal, [ c] making eye contact, and [ d ] writing a letter.
Effective interaction necessitates an understanding of various non-verbal communication techniques.
Three right solutions to this question include:
Writing down your thoughts and experiences in a journal is one strategy that can be effective for nonverbal communication of emotions and ideas. Visually connecting: This non-verbal prompt can convey consideration, interest, and once in a while even feelings with next to no expressed words. Composing a letter: This type of composed correspondence permits people to pass on definite messages without the requirement for verbal cooperation.Written and nonverbal cues are used in these strategies to communicate effectively without speaking.
Stress can cause the body to tense up as a defense mechanism. Which body system would this affect?
A. Digestive system
B. Musculoskeletal system
C. Endocrine system
D. Nervous system
Stress primarily affects the d) nervous system, initiating muscle tension and physiological changes for survival during the "fight-or-flight" response. Chronic stress can also suppress functions of other systems such as the immune and digestive systems.
Stress can cause the body to tense up as a defense mechanism, largely affecting the nervous system (D). When stress occurs, the body activates the "fight-or-flight" response through the autonomic nervous system, leading to increased heart rate, rapid breathing, and muscle tension aimed at immediate survival.
Digestive system: This system is responsible for digestion and processing of food, but during stress, its activity is often suppressed in favor of survival functions.Musculoskeletal system: This system includes muscles and bones; while stress can cause muscle tension, it is not the primary system affected by stress.Endocrine system: The system that involves hormone production; it interacts with the nervous system during stress by releasing hormones like cortisol.Nervous system: This is the primary system affected by stress, initiating the "fight-or-flight" response and causing muscle tension and other survival mechanisms.When exercising, you should
A. plan to take in extra protein. B. plan to take in extra water. C. work through any pain that you experience. D. avoid wasting time with a warm-up.
Brianâs need for a vitamin is 100 milligrams each day. the bioavailability of this vitamin is 35%. this means that brian needs to consume _____ milligrams each day for this vitamin to meet his needs.
The answer to this question is that Brian needs to consume 135 milligrams a day of the vitamins to meet his needs.
Bioavailability is the portion of a medicine, drugs, or substance that was intake by a person in order for this substance to be fully effective. Bioavailability is also the required dosage for the medicine or substance to be absorbed by the body.
True or false, guns are difficult to obtain by abiding- citizens
What is life expectancy of obese people? What is life expectancy of obese people?
Answer: obese can lead to having heart problems or diabetes
Explanation: But it is preventable if you exercise,Instead of sitting at your TV, And eating healthy. Sometimes you can be obese and will be very hard to prevent.
The number one sexually transmitted disease in the united states is aids.
a. True
b. False
Isostatic stretching refers to what
Isostatic stretching is a type of stretching that involves contracting the muscle group being stretched. This type of stretching is thought to be more effective at increasing flexibility than static stretching, which is the traditional type of stretching that involves holding a position for a period of time.
To perform an isostatic stretch, you first need to identify the muscle group you want to stretch. Once you have identified the muscle group, you need to contract it while also moving the joint in the direction of the stretch. For example, to stretch the hamstring muscle, you would stand up and bend at the waist, reaching for your toes. As you reach for your toes, you would also contract your hamstring muscles. You should hold the stretch for 10-30 seconds.
Isostatic stretching can be done for any muscle group, but it is especially beneficial for muscles that are tight or inflexible. Isostatic stretching can help to improve your range of motion and reduce your risk of injury.
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Jason suffered painful withdrawal symptoms after he stopped using heroin. this was most likely due to his brain's reduced production of
Laura and mark are new parents whose baby cries for three to four hours a day for no apparent reason. laura and mark have had their baby examined by a pediatrician who was unable to find any medical reason for the excessive crying. laura and mark's baby appears to be suffering from:
You are driving too slowly if you
block other vehicles moving at normal safe speeds
do not pass other vehicles often
drive at speeds less than the posted speed limit
drive at speeds less than 40 miles per hour on any highway
You are driving to slowly if you:
A. Block other vehicles moving at normal safe speeds,
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Why is the principle of progression essential to increasing fitness? Name two ways progression can be applied to a fitness program.
The principle of progression states that you should increase overload, which can be achieved by using FITT (frequency, intensity, time, and type) when your body adapts to its present routine. The specificity principle states that only targeted exercises will improve specific fitness goals.
The principle of progression in fitness involves gradually enhancing your workouts to improve fitness levels and prevent plateaus. It can be applied by increasing the intensity of workouts or the frequency of exercise sessions.
Explanation:The principle of progression is crucial to increasing fitness because it involves gradually increasing the intensity, frequency, or time of your workouts to improve your fitness level. This concept is essential as it prevents plateaus in fitness development and reduces the risk of injury.
There are two ways that progression can be applied to a fitness program:
Increasing Intensity: This is often achieved by adding more weight or resistance to your workouts. For example, if you usually lift 10 kilograms, you could progress by lifting 11 or 12 kilograms.Increasing Frequency: This refers to the number of exercise sessions per week. If you're used to working out three days a week, you could progress to four or five days.Learn more about Principle of Progression here:https://brainly.com/question/32216287
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Kenethia enjoys knitting. when she begins college, she has less time for knitting and finally stops altogether. after graduation, she wants to knit again, so she practices with her needles until she is good at it again. this is an example of ________, a means of retrieving information out of your long-term memory storage system.
This is an example of relearning, a means of retrieving information out of your long-term memory storage system
The relearning method involves the process of trying to regain activities or knowledge of materials that a person has learned and can no longer remember any more. Relearning is also known as the saving method, this method can be used to measure how quickly individuals can remember what they learned and forgotten.
Further ExplanationRelearning is one of the three ways that a person can retrieve information out of the long term memory system. It has to do with learning something that you have previously learned.
A perfect example of relearning is the picture painted in the given question. Kenethia is good at knitting and she stops doing it because of other engagement (school activities). Kenethia tries to go back to knitting after graduation but discovers she’s no better at it. Therefore, she needed to practices with a needle to master the act again.
This technique is called relearning and it is one of the ways a person can retrieve information from their memory.
Some other ways a person can retrieve information from long term memory include
RecallRecognitionTherefore, this is an example of relearning, a means of retrieving information out of your long-term memory storage system
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Kenethia enjoys knitting. When she begins college, she has less time for knitting and finally stops altogether. After graduation, she wants to knit again, so she practices with her needles until she is good at it again https://brainly.com/question/14370169Celia loved to knit when she was a young girl, but she hadn't done it in years https://brainly.com/question/13800975KEYWORDS:
knittingneedlesrelearningmemory storage systemretrieving informationSedentary behavior while healing from a hip fracture would most likely predispose the older patient to:
Sedentary behavior while healing from a hip fracture would most likely predispose the older patient to Muscle weakness and loss of muscle mass, Reduced range of motion and stiffness, Decreased bone density, Diminished cardiovascular health, and Impaired balance, and coordination.
1) Muscle weakness and loss of muscle mass: Lack of physical activity can lead to muscle atrophy and decreased strength, especially in the muscles surrounding the injured hip. This can hinder mobility and increase the risk of future falls.
2) Reduced range of motion and stiffness: Prolonged inactivity can result in joint stiffness and limited range of motion, making it more challenging for the patient to regain mobility and function in the hip joint.
3) Decreased bone density: Lack of weight-bearing activity during healing can contribute to reduced bone mineral density, increasing the risk of osteoporosis and future fractures.
4) Diminished cardiovascular health: Sedentary behavior can negatively impact cardiovascular fitness and overall cardiovascular health, potentially leading to increased fatigue, shortness of breath, and decreased endurance.
5) Impaired balance and coordination: Lack of movement and physical activity can affect balance and coordination, making the patient more susceptible to falls and further injury.
Therefore, Sedentary behavior while healing from a hip fracture would most likely predispose the older patient to Muscle weakness and loss of muscle mass, Reduced range of motion and stiffness, Decreased bone density, Diminished cardiovascular health, and Impaired balance, and coordination.
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Juliana’s exercise partner is running a high fever and feels nauseous. She also has a rapid heart rate. What should Juliana do?
Medical decision making (mdm) is based on the ____ the physician must consider about the management of a patient’s condition.
MDM is a crucial aspect of healthcare that involves the information, complexity, and clinical knowledge needed to manage a patient's condition. Factors include patient history, diagnostic tests, and potential risks.
Explanation:Medical Decision Making (MDM) is based on the information and complexity the physician must consider in the management of a patient's condition. This includes gathering and analyzing patient history, performing examinations, and applying clinical knowledge to manage the patient's health. Information like the number and type of diagnostic tests, the risk of complications and/or morbidity and mortality, and the amount of data to be reviewed are key factors in MDM.
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While inspecting the skin of a child, the nurse notes blotchy areas of hemorrhage. the nurse documents these as:?
A nurse preparing a section of skin for an injection is an example of __________.
Match the following.
1. Defends your body from any organisms that threaten the destruction of cells 2. White blood cells that produce antibodies.
3. System of vessels that are responsible for the removal of bacteria from the bloodstream.
4. Outer layer of the skin which, along with other functions, makes the body waterproof.
5. Inner layer of skin which contains blood vessels, sweat glands, hair follicles, and nerve cells.
A: Dermis
B: Epidermis
C: Lymphocytes
D: Lymphatic system
E: Immune system
The right matches are:
A: Dermis ==> 5
B: Epidermis ==> 4
C: Lymphocytes ==> 2
D: Lymphatic system ==> 3
E: Immune system ==> 1
Invisible to our eyes, it nevertheless ensures the guard, day and night. Whether it is to cure otitis or cancer, the immune system is essential.
The immune system is made of a complex system of interactions involving many different organs, cells and substances. The majority of cells are not in the blood, but rather in a set of organs called lymphoid organs.
The skin (the epidermis and the dermis) also contributes to the imunity of the body as a protective barrier against aggressors.
Mel and her doctor are trying to decide which medication mel should use to reduce her psychotic symptoms. her doctor told her that the first-generation dopamine-blocking drugs can have side effects such as:
Evan forgot his anniversary with his girlfriend, and her feelings were hurt. The next day, he bought her flowers, and she was thankful, but she instantly started sneezing. It turned out Evan had forgotten she was allergic to those flowers. Tomorrow is his girlfriend's birthday, and Evan wants to take her on a date, but he thinks she would probably have more fun with her friends. He is considering not going out with her at all because he feels so down about himself. What has most likely happened to Evan?
8.
You do not need to wear sunscreen in the winter.
True
False
9.
Approximately how many different sexually transmitted diseases are there?
95
over 500
6
25
10.
Communities can make their neighborhoods safer by
warning people not to come outside.
starting a Neighborhood Watch program.
turning off the street lights at night.
hiring fewer police officers.
Match the phrase with the correct explanation from the chapter.
1. strengthens the bones isotonic exercise
2. using leg weights to strengthen the leg muscles stronger bones
3. flexing your leg muscles for 30 seconds without moving isometric exercise
4. causes a light-headed feeling during resistance training resistance training
5. the ratio of fat to non-fat tissue in the body improved weight maintenance
6. increased with resistance training body composition
7. fewer excess calories are turned into fat storage resting metabolic rate
8. made more dense with resistance training Valsalva maneuver
1. resistance training
2. isotonic exercise
3. isometric exercise
4. Valsalva maneuver
5. body composition
6. resting metabolic rate
7. improved weight maintenance
8. stronger bones
Blank who share the road with an impaired driver are at risk
Answer:
All kinds of people
Explanation:
The nurse is caring for a client who has been diagnosed with glomerulonephritis. which initial urinary finding supports this diagnosis?