Which is responsible for supervising and coordinating health care services for enrolled?

Inhaltsverzeichnis Show

Nursing Team
Allied Health Professionals
Case Coordinator and Social Worker
Housekeeper
Identifying Your Care Team Members
Examples of Primary Care Provider (PCP) in a sentence
More Definitions of Primary Care Provider (PCP)
Which is responsible for supervising and coordinating health care services for enrollees?
Who is responsible for the health of a group of enrollees and can be a health plan hospital physician group or health system?
Who is responsible for reviewing health care provided by managed care organization?
Which of the following is an organization that provides health services on a prepaid basis?

During your stay, you may meet a number of healthcare professionals who work together to coordinate your care. We encourage you to speak up, ask questions, and let your needs and concerns be known. Here are some common healthcare professionals who will help care for you during your stay.

Physician

The physician in charge of coordinating and delivering your care is called the attending physician. This may be your primary care physician, one of our hospitalists, or another doctor assigned to you. A hospitalist is a physician who specializes in the care of hospitalized patients. You may also be seen by other medical or surgical specialists, as well as by residents, physician assistants, and advanced practice nurses. Residents are physicians who are in training programs for a particular specialty.

Nursing Team

A registered nurse (RN) is designated as your primary nurse. He or she plans and coordinates your overall plan of care along with your physician and other members of the team. The RN also assigns tasks to the patient care associates and patient care technicians (PCAs/PCTs). In each patient care unit, the staff is led by a nurse manager (a registered nurse who is responsible for supervising patient care and coordinates other registered nurses and all nursing and support staff of the unit). Nursing staff functions on a 24/7 basis; nursing supervisors during the evenings, nights and weekends/holidays have managerial oversight for the entire hospital.

Allied Health Professionals

Physical therapists, occupational therapists, respiratory therapists, speech pathologists, audiologists, and other therapists may work with you, your family, and your medical team to help meet recovery goals.

Case coordinators and social workers will assist you and your family with planning for your needs when you leave the hospital.

A case coordinator is a RN who will help arrange for visiting nurse services at home, going to inpatient rehabilitation, or any necessary medical equipment. The case coordinator also reviews your case with your physician to make sure you are receiving the appropriate level of care while in the hospital.
A social worker can address the emotional issues that come with being in a hospital, provide patient and family counseling, and connect you with services in the community.

Pharmacist

A pharmacist is responsible for reviewing each medication ordered in the hospital and making sure the dose, route, and schedule are the best possible for you. Our pharmacists work very closely with your other healthcare providers to make sure you are getting great care, and to reduce the chance of having side effects from your medication. If you would like to talk to a pharmacist about your medication, ask your nurse to contact the pharmacy. Pharmacists may also stop by to talk to you about new medications and changes in your home medications before your discharge.

Dietitian

A registered dietitian will review your medical record and work with your healthcare team to develop a nutrition care plan for you. Registered dietitians provide nutrition education and diet instruction about any diet you may need to follow after you are discharged. A nutrition assistant will help you order meals and assist with tray delivery along with the dietary worker.

Housekeeper

A housekeeper specially trained in hospital sanitation cleans your room every day. If your room needs attention at any time in between normal cleanings, call the Environmental Services Department at 201-894-3035.

Identifying Your Care Team Members

To help you easily identify the role of people on your care team, our uniforms are color-coded. Here are some of the common uniforms and colors you will see.

Examples of Primary Care Provider (PCP) in a sentence

Select a Primary Care Provider (PCP) who is accepting new patients.
A Primary Care Provider (PCP) is a network physician who is selected by you to provide and coordinate your covered services.
Additionally, the ACO or MCO is responsible for ensuring that the CP Assigned Enrollee’s Primary Care Provider (PCP) or PCP designee reviews, approves, and signs the member’s care plan.

More Definitions of Primary Care Provider (PCP)

Primary Care Provider (PCP) means a participating provider who has the responsibility for supervising, coordinating, and providing primary health care to enrollees, initiating referrals for specialist care, and maintaining the continuity of enrollee care. PCPs include, but are not limited to Pediatricians, Family Practitioners, General Practitioners, Internists, Physician Assistants (under the supervision of a physician), or Advanced Registered Nurse Practitioners (ARNP), as designated by the Contractor. The definition of PCP is inclusive of primary care physician as it is used in 42 CFR 438. All Federal requirements applicable to primary care physicians will also be applicable to primary care providers as the term is used in this Contract.

Which is responsible for supervising and coordinating health care services for enrollees?

Primary Care Provider means a person responsible for supervising, coordinating, and providing initial and Primary Care to patients; for initiating referrals; and, for maintaining the continuity of patient care. A Primary Care Provider may be a Primary Care Physician (PCP) or Non-Physician Medical Practitioner.

Who is responsible for the health of a group of enrollees and can be a health plan hospital physician group or health system?

Chapter 3.

Who is responsible for reviewing health care provided by managed care organization?

CMS is responsible for reviewing and approving state requests to implement managed care under these authorities. All Medicaid managed care programs, regardless of authority, are subject to the provisions of Section 1932 and 42 CFR 438 unless specifically waived.

Which of the following is an organization that provides health services on a prepaid basis?

HMOs provide medical care for their patients for a prepaid fee. Compared to other common health insurance plans, such as preferred provider organizations (PPOs), HMOs are generally less expensive. Patients with an HMO must have a primary care provider (PCP).