Capitation - Study guides, Class notes & Summaries
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C425 Healthcare Delivery, Regulation, and Compliance (WGU) Q&A
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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...
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AMCA CERTIFICATION TEST - MEDICAL ASSISTING STUDY GUIDE - SET A latest 2022
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AMCA CERTIFICATION TEST - MEDICAL ASSISTING STUDY GUIDE - SET A latest 20221) Which of the following is considered a parasitic infection? 
A. Lyme disease 
B. Rabies 
C. Ringworm 
D. Malaria 
... 
 
 
 
2) Aspirin and acetaminophen are examples of: 
A. Analgesics and antipyretics 
B. Antitussives and decongestants 
C. Antihistamines and antiemetics 
D. Antidotes and antibiotics 
... 
 
 
 
3) Demerol 75 mg, IM every 4 hours, as needed for severe pain, is what type of medication order? 
A. Single...
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IACCP MASTER QBANK 2023-2024 QUESTIONS WITH VERIFIED SOLUTIONS GRADED A+ The SMC Capital, Inc. No-Action Letter (September 5, 1995) states that trade allocations may occur: A. Only on a rotational basis B. On a pro rata basis but other allocation meth
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IACCP MASTER QBANK QUESTIONS 
WITH VERIFIED SOLUTIONS GRADED A+ 
The SMC Capital, Inc. No-Action Letter (September 5, 1995) states that trade 
allocations may occur: 
A. Only on a rotational basis 
B. On a pro rata basis but other allocation methods can be used without violating 
the Advisers Act 
C. Only on a pro rata basis 
D. Based on the trader's good faith discretion - CORRECT ANS B. On a pro 
rata basis but other allocation methods can be used without violating the 
Advisers Act...
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HSA 402 exam 1 || Questions and 100% Accurate Answers.
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capitation correct answers payment to health care providers on the basis of the number of people covered instead of payment for the services provided. 
 
care mgmt correct answers the process of developing and managing the care of a patient or resident, focusing on the quality of care delivered. 
 
care planning correct answers the process of developing a plan of care for a patient or resident. 
 
CARF international correct answers an organization that accredits rehabilitation and human services...
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Final exam life and health questions and answers 2024
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Risk - answer-Risk is the uncertainty of loss 
Capitation - answer-Capitation payments are payments agreed upon 
in a capitated contract by a health insurance company and a medical 
provider. They are fixed, pre-arranged monthly payments received by 
a physician, clinic or hospital per patient enrolled in a health plan, or 
per capita. 
Under a health maintenance organization HMO service providers are 
paid a fixed monthly fee for each member. This concept is called - 
answer-Capitation 
When ca...
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AAHAM CRCE 2023 EXAM STUDY GUIDE WITH COMPLETE SOLUTION
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1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 
 
3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided ...
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HIM 1121 Medical Billing Practices Review || with 100% Accurate Solutions.
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Calculate the amount of money a patient would owe for a noncovered service costing $900 if their indemnity policy has a coinsurance rate of 80-20, and they have already met their deductible correct answers $900 
 
Calculate the monthly capitation payment a provider should receive from a health plan if they have 80 contracted patients and a capitated payment of $40 per month correct answers The monthly capitation payment would total $3,200 (80 x $40 = $3,200). 
 
A capitated payment amount is cal...
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CSPR – Questions and Answers based on full course
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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...
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PTCB Practice Exam 2024
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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 answerA. Names of medications 
 
Which of the following injectable drugs would be stored in refrigerator? 
 
A. Clindamycin 
B. Ciprofloxacin 
C. Cyanocobalamin 
D. Calcitonin-salmon - correct answerD. Calcitonin-salmon 
 
The requirement that a non-formulary medication be covered ...
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Finance Test 1 || with Complete Solutions.
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Management functions correct answers key functions of a manager including planning, organizing, staffing, directing & controlling 
 
Management connective processes correct answers mgmt functions that connect elements of the healthcare org. including communicating, coordinating and decision making 
 
Joint Commission correct answers primary accrediting organization for healthcare orgs. 
 
Healthcare Financial Mgmt Association (HFMA) correct answers Association of healthcare financial managers; c...
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