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CSPR- Certified Specialist Payment Rep (HFMA) questions and answers Graded A+
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CSPR- Certified Specialist Payment Rep (HFMA) Exam
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CSPR Certified Specialist Payment RepHFMA
Steps used to control costs of managed care include: - answersBundled codes
Capitation
Payer and Provider to agree on reasonable payment
All of the above
DRG is used to classify - answersInpatient admissions for the purpose of reimbursing
hospitals for each case in a given category w/a negotiated fixed fee, regardless of the
actual costs incurred
Identify the various types of private health plan coverage - answersHMO
Conventional
PPO and POS
HDHP/SO plans - high-deductible health plans with a savings option; Private - Include
higher patient out-of-pocket expenditures for treatments that can serve to reduce
utilization/costs.
All of the above
Managed care organizations (MCO) exist primarily in four forms: - answersHealth
Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
Point of Service (POS) Organizations
Exclusive Provider Organizations (EPO)
All of the above
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