Capitated payment method - Study guides, Class notes & Summaries

In which type of healthcare payment method, does the healthcare plan recompense providers each month with a set amount of money for each individual enrolled in the healthcare plan? Capitated rate In which type of healthcare payment method does the healthcare plan pay for each service that a provider renders Fee-for-service reimbursement Which healthcare payment method does Medicare use to reimburse physicians based on the cost of providing services in terms of effort, overhead, and malpractice...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

RHIA Domain 4 Practice Test with Complete Solutions A patient is admitted to the hospital with shortness of breath and congestive heart failure. The patient undergoes intubation with mechanical ventilation. The final diagnosis documented by the attending are: Congestive heart failure, mechanical ventilation, and intubation. Which of the following actions should the coder take in this case? - Answer-Query the attending physician as to the reason for the intubation and mechanical ventilation to...

Allowable fee - ANSWER Average or maximum amount the third-party payer will reimburse providers for the service Block grant - ANSWER It is a fixed amount of money given or allocated for a specific purpose. Ex. Medicare's payment system for home health services are consolidated into the single payment Capitated payment method - ANSWER It is a method of payment for health services in which the third-party payer reimburses providers a fixed, per capita amount for a period. "Per capita...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

Allowable fee correct answers Average or maximum amount the third-party payer will reimburse providers for the service Block grant correct answers It is a fixed amount of money given or allocated for a specific purpose. Ex. Medicare's payment system for home health services are consolidated into the single payment Capitated payment method correct answers It is a method of payment for health services in which the third-party payer reimburses providers a fixed, per capita amount for a perio...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

CCA Exam Prep Domain 2 Questions & Answers 2023/2024 Allowable fee - ANSWER-Average or maximum amount the third-party payer will reimburse providers for the service Block grant - ANSWER-It is a fixed amount of money given or allocated for a specific purpose. Ex. Medicare's payment system for home health services are consolidated into the single payment Capitated payment method - ANSWER-It is a method of payment for health services in which the third-party payer reimburses providers a...