Posted: February 15th, 2022
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Learning Goal: I’m working on a nursing case study and need an explanation and answer to help me learn.
Right about this audio file, whatever he talks, that is the topic.
This is medical based program, what is medical means, Medi California, otherwise it called Medicare national program.
So, it’s a medical based program and it’s volunteer based program, the first person that do anything to the person or a child, like hey I want my dad and mom be a part of the program, let me check their medical, what I do I take their id, social, one I see the person has corresponding hmo, anthem blue, healthnet, LA care etc then I say ok, fine let’s proceed to the next step.
The next step is history and physical and they need to take this to their doctor, you know why? Because they are not my patients, they are participants here of a program that is made for adults. it’s called community-based adults services.
You’ll see adhc everywhere, there is no more, even though our says daily dreams adhc, that is the part of the business name, so therefor it stays, but this program is called community based adult services. History and physical give to them gets to the doctor , doctor will decide where her or his patient will come to replace like this or not.
So they decide they give me the diagnosis, the medication, their parameters of blood pressure, sugar level and then on the sheets there is a spot yes I don’t mind my patient goes to an adult care health center. So, doctor number 2, they give me the history and physical back , I take those and I already figured out the person is with la care, health net whatever, I take that piece of paper to have face to face request form, I fill out the face to face request form send it to correspond hmo, hmo gets the history and physical, in a couple of weeks I am going to do face to face interview with this person, pandemic we are doing a telehealth , as a post to seeing them one o one face to face, they’re doing it over the phone now. They do the face to face and they have not only the history and physical in front of them to see how they may diagnosis or how heavy their diagnosis are and they have their own rubric as well, with the interview that they do and those two things they decide if the person will get one day or two, three, four days of service at the place like this. There you have a diagnosis psych and staff like this, yes the man check you get the five four days , every other person will probably get 3 days, do I have 2 day people? I do. It is their choice do I have a 3 day person that to be 5 ? yes , but that their choice why because this is a voluntary program. So, if it was not legitimized in that sense that it will be all fraud, I mean, I can just get you and get your medical card and sit you down and say I am making money out of this , well that is not right obviously, that Is bad practice, you don’t want to do that , but the way of that, they set up a system you can’t do fraud.
Requirements: 250 words | .doc file
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