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DPH 428 Exam 2 Study Guide questions and answers (100- accuracy).
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DPH 428 Exam 2 Study Guide questions and answers (100- accuracy).
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DPH 428 Exam 2 Study Guidequestions and answers (100%
accuracy)
captivated rates - answer set rate for serving enrolled patients
third party payers - answer insurance, companies, managed care
organizations, and the government
prospective reimbursement - answer used by managed care
organizations (employers pay premium for employees)
utilization review - answer evalutes appropriateness of provided
services
perspective review - answer implemented before service; care
provider can access/refer
concurrent utilization review - answer decisions made during
service; ex. how long you stay in hospitals
per member for MCO payment plan - answer member fee paid
regardless of how often each member uses services
discounted fees of MCO payment plan - answer discounted based on
a fee schedule (doc provides services & can bill MCO by schedule)
lab technologists/technicians (ex. lab technologist) - answer type of
allied health profession
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