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CPB Chapter 2 Glossary, Questions and answers, 100% Accurate, Rated A+
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CPB Chapter 2 Glossary, Questions and answers, 100% Accurate, Rated A+ Accountable Care Organizations (ACO) - -A healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care fo...

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  • February 8, 2023
  • 4
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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CPB Chapter 2 Glossary, Questions and
answers, 100% Accurate, Rated A+

Accountable Care Organizations (ACO) - ✔✔-A healthcare organization characterized by a payment and
care delivery model

that seeks to tie provider reimbursements to quality metrics

and reductions in the total cost of care for an assigned population of patients.



Capitation - ✔✔-Fixed payment remitted at regular intervals to

a medical provider by a managed care organization for an enrolled patient.



Carve-out - ✔✔-A service not covered in a health insurance

contract, usually reimbursed according to a different arrangement or rate formula than those services
specified under the

contract umbrella.



Consumer Driven Health Plans (CDHP) - ✔✔-Third tier insurance plans that give the members more
control over their health budgets.



Copay - ✔✔-A specified dollar amount the policyholder must

pay to a healthcare provider for each visit or medical service received. This is typically found on the
insurance card.



Credentialing - ✔✔-A process that is used to evaluate the qualifications and practice history of a
physician which includes a

review of a physician's completed education, training, residency, and licenses.



Customized Sub-Capitation (CSC) - ✔✔-Managed care plan in which healthcare expenses are funded by
insurance coverage;

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