Capitation - Study guides, Class notes & Summaries

Exam 3: PNR207 / PNR 207 (Latest Update 2024 / 2025) Transition to PN Practice - Capstone | Review Guide Questions and Verified Answers | 100% Correct | Grade A - Fortis Question: Reimbursement based on negotiated costs Answer: Retrospective payment system Question: System in which federal government announces to a hospital in advance what it will pay for each client based on the clients DRG category, regardless of the length of stay Answer: Prospective payment system ...

_____ is the recording of all treatments, diagnoses, and other medical services. It is commonly done electronically but may be done on paper. - ️️charge capture ____ is the process of translating treatments, diagnoses, and other medical services into established alphanumeric codes so that they can be submitted as part of a claim. - ️️coding When a healthcare organization such as a physician group receives a per-head fee for each individual enrolled in a plan, it is known _____. A c...

Healthcare Reimbursement Final Exam Questions and Answers Already Passed What is the difference between direct and indirect costs in healthcare? Direct costs are expenses directly tied to patient care, such as salaries and medical supplies, while indirect costs are overhead expenses, like administrative salaries and utilities. What role do diagnosis-related groups (DRGs) play in reimbursement? DRGs categorize hospital cases into groups that determine the fixed payment amount for i...

Healthcare Reimbursement Methodologies Chapter 1: Questions and Answers 100% Pass What is healthcare reimbursement? Healthcare reimbursement is the process by which healthcare providers receive payment for the medical services they provide to patients. How do healthcare reimbursement methodologies affect patient care? Reimbursement methodologies influence how providers deliver care by creating incentives for specific types of services or treatments and by affecting the cost t...

What is respondeat superior or vicarious liability? - ANSWER ☑☑it is when an employer is responsible for the actions of their employees. Both terms essentially mean the same thing. what is res ipsa loquitur? - ANSWER ☑☑it is when a physician acts negligently to lead to an accident. the thing speaks for itself Example is if a physician prescribes the wrong medication leading to injury or leaves a scalpel inside someone . What is contributory negligence? - ANSWER ☑☑it is...

Capitation A covers all services an enrollee may need during an entire year Market Justice most equitably distributed through the market forces of supply and demand, rather than government interventions. Distributed on the basis of willingness and ability to pay Social Justice An ideal that embraces all aspects of civilized life and that is linked to fundamental notions of fairness and to cultural beliefs about right and wrong. defensive medicine Ordering more tests and procedures than...

Comprehensive Test- Principals of Healthcare Reimbursement and Revenue Cycle Management Review with Complete Solutions What is the primary function of revenue cycle management in healthcare? The primary function of revenue cycle management is to oversee and optimize the financial processes from patient registration to final payment, ensuring timely and accurate reimbursement. How does patient registration impact the revenue cycle? Patient registration is crucial because accura...

PTCB EXAM 2024 WITH 100% ACCURATE SOLUTIONS Knowing which of the following can best assist a technician in the prevention of data entry errors? A. Names of medications B. Insurance co-payments C. Pharmacokinetics D. Physician contact information - correct answer A. Names of medications Which of the following injectable drugs would be stored in refrigerator? A. Clindamycin B. Ciprofloxacin C. Cyanocobalamin D. Calcitonin-salmon - correct answer D. Calcitonin-salmon The requ...

HFMA's CSAF 2024, Certified Specialist Accounting and Finance. Exam Questions and Answers 100% Pass Contribution Margin - answerDifference between marginal revenue and marginal cost. Break-even point - answerLevel of sales volume of a product producing the exact amount of contribution margin needed to cover fixed costs. Overhead - answerIndirect Costs Activity-based costing (ABC) - answerMethod of determining product costs using cost drivers or activity measures, which cause indirect ...

Maine Life Insurance Exam Questions With Complete Solutions. Contributory Health Insurance If the employees share a portion of the premium. Often require participation by 75% of eligible members. Noncontributory Health Insurance If the employer pays the entire premium. Most require 100% participation by eligible members. (Funding of Group Insurance) Shared funding Allows employer to self-fund health care expenses, select a deductible and pay covered expenses for any individual incurring ...