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Reimbursement Methodologies Exam 3 Questions and Answers Already Passed $9.99   Add to cart

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Reimbursement Methodologies Exam 3 Questions and Answers Already Passed

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Reimbursement Methodologies Exam 3 Questions and Answers Already Passed What does "reimbursement methodology" refer to in healthcare? a. The process of hiring healthcare providers b. The system used to determine how healthcare providers are paid for services rendered c. The coding systems fo...

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  • September 29, 2024
  • 19
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Reimbursement Methodologies
  • Reimbursement Methodologies
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Reimbursement Methodologies Exam 3
Questions and Answers Already Passed
What does "reimbursement methodology" refer to in healthcare?

a. The process of hiring healthcare providers


✔✔b. The system used to determine how healthcare providers are paid for services rendered


c. The coding systems for diagnoses

d. The administrative tasks involved in patient care




How do managed care organizations typically influence reimbursement?


✔✔a. By negotiating payment rates and controlling healthcare costs


b. By increasing the number of services provided

c. By standardizing patient treatment across all providers

d. By eliminating the need for insurance




What is the structure of the global budget payment model?

a. Payments based on each individual service provided

b. A flat fee per patient visit


✔✔c. A fixed total payment for all services over a specified time period

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,d. Payment determined by patient satisfaction scores




What is the primary purpose of cost-sharing in healthcare plans?

a. To simplify billing processes


✔✔b. To reduce overall healthcare expenditures by having patients pay a portion of the costs


c. To increase healthcare provider salaries

d. To eliminate out-of-pocket expenses for patients




How do bundled payments encourage care coordination among providers?

a. By requiring separate billing for each service


✔✔b. By providing a single payment for multiple related services, promoting collaboration


c. By limiting the types of services that can be offered

d. By penalizing providers for unnecessary services




Which of the following is a disadvantage of fee-for-service reimbursement?

a. It rewards high-quality care

b. It allows for flexibility in treatment


✔✔c. It may lead to overutilization of services


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, d. It encourages preventive care




What does the term "capitation" mean in healthcare reimbursement?

a. Payment per individual service provided


✔✔b. A fixed payment per patient per time period, regardless of services used


c. A fee based on the complexity of care

d. A bonus for meeting quality metrics




What is the role of the Current Procedural Terminology (CPT) codes in medical billing?

a. To classify diseases and conditions


✔✔b. To describe specific medical, surgical, and diagnostic services for billing


c. To track healthcare outcomes

d. To determine insurance eligibility




What is the function of the International Classification of Diseases (ICD) coding?

a. To evaluate patient satisfaction

b. To classify services rendered


✔✔c. To classify diagnoses for billing and reimbursement purposes


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