Cspe - Study guides, Class notes & Summaries

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient 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 - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

CSP Specialty Pharmacy Exam | 100% Correct Answers | Verified | Latest 2024 Version

CSPR - Certified Specialist Payment Rep (HFMA) 2024 Questions With Complete Solutions.

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CSP Exam Study Guide (Certified Specialist In Psychometry)

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers Inpatient 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 correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

CSP exam test 2024 (specialty pharmacy)With Correct Answers!! PDC calculation - (# of unique days with supply / number of days in a period) x 100 Jak inhibitor - Xeljanz (tofacitinib) Cholesterol-elevating medication - Actemra (toclizumab) Shingles vaccine safe with TNF inhibitors - Shingrix Neutropenia risk - Taltz (ixekizumab) Psoriasis medication without tuberculosis screening - Otezla (apremilast) Standard starting dose for Taltz (ixekizumab) in psoriatic arthritis - 160mg subcutaneo...

CSPR - Certified Specialist Payment Rep (HFMA) Exam (Latest 2024) Questions & Verified Answers 100% Guaranteed Grade A+ Example Question & Answer: Identify the various types of government‐sponsored health coverage: - Answer - Medicare - Government; Beneficiaries enrolled in such plans, but, participation in these plans is voluntary. Medicaid Medicaid Managed Care - Medicaid beneficiaries are required to select and enroll in a managed care plan. Medicare Managed Care (a.k.a. Medicare ...

What is tiering? - Ans: The ranking or classifying of one or more of the provider delivery system components Which option is a practice used to control costs of managed care? - Ans: -Making advance payment to providers for all services needed to care for a member -Combining services provided and bundling the associated charges -Agreement between the payer and provider on reasonable payment for each service. Which option is a risk involved in per diem payments? - Ans: -The risk to the ins...