Prospective payment - Study guides, Class notes & Summaries

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

HFMA CRCR (ACTUAL) EXAM | 170 QUESTIONS AND VERIFIED SOLUTIONS 2024/2025 IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - CORRECT ANSWER- They must be billed separately to the part B Carrier what is a recurring or series registration? - CORRECT ANSWER- One registration record is created for multiple days of service What are nonemergen...

NY Series 17-52 Questions and Answers 100% Pass How many eligible employees must be included in a contributory health insurance plan? 50% A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, The insurance through his company is primary. What is the period of coverage for events such as death or divorce under COBRA? 36 months Twenty-five days after ...

At what point must a life insurance applicant be informed of their rights that fall under the Fair Credit Reporting Act? - ANSWER Upon completion of the application Who elects the governing body of a mutual insurance company? - ANSWER policyholders An insurance applicant MUST be informed of an investigation regarding his/her reputation and character according to the - ANSWER Fair Credit Reporting Act What type of reinsurance contract involves two companies automatically sharing their ri...

Which of the following is true in regards to health care today in the United States? There are more primary care physicians than specialty physicians. Primary care receives a higher reimbursement in professional fees. There are more specialty physicians than primary physicians. Outpatient care is slowly decreasing. - ANSWER-There are more specialty physicians than primary physicians. What triggered the downsizing phase in the U.S. hospital industry during the 1980s? Hill-Burton Act Mana...

What are 2 main types of dialysis? - Correct Answer Hemodialysis and peritoneal dialysis How are dialysis clinics paid by Medicare? - Correct Answer Prospective payment system bundles What does "Pay for performance" mean - Correct Answer Clinics that dont meet certain quality standards will have their payments cut Which of the following are dialysis clinics required to work with - Correct Answer ESRDS networks Which of the following is a responsibility of the ERDS networks? - Correct Answe...

DENTAL PUBLIC HEALTH & RESEARCH Contemporary Practice for the Dental Hygienist Fourth Edition Brief Contents UNIT I INTRODUCTION TO DENTAL PUBLIC HEALTH  1 UNIT III DENTAL HYGIENE RESEARCH  179 1 Dental Public Health: An Overview  2 14 Research in Dental Hygiene  180 2 The Prevention Movement  17 15 Ethical Principles in Research  187 3 Dental Care Delivery in the United States  34 16 The Research Process  195 4 Dental Hygiene Care Delivery in the Global Community 47 17 Biostat...

CFCM Study Guide- FULL TEST new exam update solved solution guide with actual questions and answers Which of the following statements is NOT true? a. The government encourages the maximum practicable commercial use of inventions made under government contracts. b. The government recognizes rights in data developed at private expense, and limits its demands for delivery of that data. c. The government requires that contractors obtain permission from copyright owners before including copy...

HFMA CRCR EXAM ALL 170+ QUESTIONS AND CORRECT ANSWERS GRADED A+ IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - answer -They must be billed separately to the part B Carrier what is a recurring or series registration? - answer -One registration record is created for multiple days of service What are nonemergency patients who come for servic...

pearson vue practice exam Questions and answers, 100% Accurate, graded A+ In stating a seller's price and terms to a prospective buyer, the seller's broker is required by the law of agency to state ONLY those terms that are a. included in the listing agreement b. based on the brokers evaluation of prevailing prices and terms c. favorable for the seller, as determined by the broker d. attractive to buyers, as determined by the broker - -a. included in the listing agreement a lot measu...