Approved teaching hospitals receive increased Medicare payments according to a(n) __________ adjustment
a. disproportionate share hospital
b. indirect medical education
c. risk of inpatient patient mortality
d. severity of inpatient illness
b
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BCBS has a mandatory second surgical opinion (SSO) requirement necessary when a patient is considering elective, nonemergency surgical care. The initial surgical recommendation must be made by a physician qualified to perform the anticipated surgery. If a second surgical opinion is not obtained prior to surgery, the patient's out-of-pocket expenses may be __________
a. eliminated b. increased c. reduced d. waived
How do diagnostic-related groups (DRGs) help control Medicare costs?
a. Assist physicians to make more accurate diagnoses b. Simplify administrative expenses c. Limit the coverage available to patients who have preexisting conditions d. Limit reimbursements to hospitals to amounts based on expected rather than actual costs of treatment