APEA 3P Exam Prep- Professional Issues/Ethics Questions and Answers with Explanations
A nurse practitioner has agreed to participate in the Medicare
... [Show More] health insurance program. Medicare paid 80% of the charges billed for a clinic visit. What can be done about the other 20% that is owed?
The NP can bill the patient for a percentage of the remainder.
The NP is prohibited from billing the patient.
The NP can collect 90% if billed incident to the MD.
The NP can resubmit the bill for additional payment.
The NP is a “participating” provider because he agreed to accept assignments. An assignment is an agreement between Medicare and the NP to accept the Medicare Approved Amount (MAA) as payment in full and not charge Medicare recipients a higher rate. The NP can bill the patient for a percentage of the remaining bill that was not paid by Medicare. The NP may opt out of participating. The NP can be reimbursed 100% if billed incident to the MD.
The name given to subjects in a research study who do not have the disease or condition being studied, but who are included in the study for comparison are:
studied subjects.
controls.
case series.
cross sectionals.
Studied subjects are those members of a study who have a specific disease or condition of interest or who are receiving a specific treatment. Case series may refer to an observational study in which a group of patients with interesting characteristics are studied. Cross sectional is a type of observational study in which a particular characteristic is studied at one time rather than over time. Controls are commonly employed in many types of research studies.
The research design that provides the strongest evidence for concluding causation is:
randomized controlled trials.
cohort studies.
case control studies.
prospective studies.
A randomized clinical trial (RCT) is the epitome of all research designs. Subjects are randomly assigned to treatment groups. This type study provides the best evidence that the results were due to the intervention and not something else. A RCT is an experimental design, not an observational one.
An older adult male with moderately severe dementia presents with his caregiver daughter. His BMI is 18. His clothes have food stains on them and he looks as though he hasn’t been bathed in days. How should the nurse practitioner handle this?
The NP should comment to the daughter about his poor care.
The NP should report this as potential elder abuse.
The patient should be asked about his care.
The daughter should be asked about the type of care he receives.
This patient presents as though he is being poorly cared for and mistreated. This occurs in about 3-8% of the adult population in the United States. There is no evidence that the patient has been physically abused, but he obviously suffers from neglect. This is a form of elder abuse, just as physical, sexual, psychological, or financial abuse is. Older adults with dementia often suffer abuse most frequently. [Show Less]