Reporting party stated that on 10/17/17, a door was closed on her daughter, Aaliyah Chavez (DOB: 02/10/16) , her right index finger. Staff told RP that the child was behind another parent who was picking up their child and staff did not see the child go behind the parent. RP stated that she sought medical attention at Kaiser Urgent Care where it was determined that the child did not have a broken finger. RP stated that the child's nail is coming off. It was also reported that on 11/17/17 when she arrived to pick up her child, she accidentally bumped into another child (male unknown) and teacher Genesis grabbed the child by his arm and roughly pulled him away. On 11/27/17, RP arrived at the facility at 3pm to pick up her child and noticed that…
As of yet, Ms. Castaneda has not authorized the claimant to be seen by a medical clinic and is waiting for…
Andrew Rider of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with John Pero and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery.…
What are Federally Qualified Health Centers (FQHCs)? It is run by the Federal Government and driven by Medicare. “The FQHC benefit under the Medicare was added effective October 1, 1991” (CMS FQHC fact sheet, n.d.). It is to ensure that all Americans regardless if they can pay for medical services is offered the same care of an individual with paying health care insurance. This service is mostly popular in the rural area of the States.…
1: Complete a one page position paper (your opinion) about current health and human services reimbursement.…
Managed care contributes a vast amount to the healthcare system. Without managed care systems I don’t think health facility, insurances agencies and companies would manage. Agree, professionals are to adapt and accommodate changes based on contracts between managed care systems and other agencies. In my opinion, the technology advancement within the health care system has improved tremendously in a positive way. For example; when I switched my daughter primary doctor around shot time, me being old fashion handed her the paper shot record. She replied “ma’am it already imported into the system; we don’t use the paper anymore.” This is totally a successful and less stressful outcome on a person if it was to get lost or misplaced. These…
For the past several years, the health care and insurance industries in America have been undergoing significant reform in order to rein in the high cost of delivering health care services. Managed care has become a cornerstone of this process (Strickland, 1995). The case management industry (with its focus on cost containment, managed competition, and quality care) is playing an increasingly important role in the managed care environment (Owens, 1996). According to Mullahy (1995a), the number of case managers has risen astronomically in recent years. These individuals come from diverse professional backgrounds and practice settings that include nursing, rehabilitation counseling, and social work.…
Community can be defined as a social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage (Dictionary.com, 2015). The health care needs of a community are contingent upon age, gender, race, and social class. This paper will address the marketing strategy of a web-based resource, walk-in clinic, and a retail clinic within one community. Research will cover the audience in which the organizations wish to target, how they market to The target audience, the effectiveness, and what could be done differently to improve marketing strategies.…
Health care is always going to be an important issue, especially when much of the population does not have coverage for one reason or another. A series of surveys were conducted in 2010 in Central Texas by the Central Texas Sustainability Project (CTSIP) to find out who had health coverage. They also asked follow up questions to those who do not have health care coverage to get the reasons why and to determine trends in their data.…
Health care in the United States is a complex business that is always changing because of many factors such as new technology, insurance changes, and currently state involvement. The United States has the highest cost of health care in the world because of many factors such as technology, reimbursement from insurance companies and covering the uninsured patient. One class of uninsured patients is illegal immigrants in the United States that are accessing the health care system. There is debate that illegal immigrants come into the United States with the sole purpose of accessing the health care system through the emergency department (ED) at hospitals because they do not have access to the level of health care in their own country. When illegal…
Policies to provide culturally and linguistically relevant mental health care and to facilitate early diagnosis are important in the attempt of keeping cost low. Exacerbation of mental health problems due to lack of insurance and inability to pay for services serve as insurmountable barrier to Hispanics receiving care (Esteban et.al, 2006). A wide range of methods that provide mental health care for undocumented Hispanics are vital in regards to the success of all initiatives working with the Hispanic community. Many Hispanic families have mixture of members who are both documented and…
Fraud and Abuse of the Medicaid and Medicare programs in the United States is a widespread and pervasive problem. Institutions, health care providers and individual consumers all have a role in fraud and abuse prevention. It impacts everyone even if you do not currently benefit from one of these government programs.…
HealthPocket; analysis: 80 percent of health plans charge higher premiums than they first quote to consumers. (2013). Managed Care Business Week, , 5. Retrieved from http://search.proquest.com/docview/1313166853?accountid=32521…
It is the concern of policy makers that Medicaid recipients are more likely to be noncompliant with regards to following a specific medical regimen, including follow-up appointments and are more likely to miss scheduled appointments. Medicaid recipients are more likely to use an emergency department as their usual source of care and more likely to lack continuity in the care they receive. Many medical providers refuse to accept a Medicaid recipient, which has increased the reimbursement in hopes to draw in providers to accepting Medicaid patients.…
Herszenhorn David M., (2009). Illegal Immigrants Could Not Buy Insurance on New ‘Exchange,’ White House Says. Retrieved from http://prescriptions.blogs.nytimes.com/2009/09/11/illegal-immigrants-could-not-buy-insurance-on-new-exchange-white-house-says/…
