Cspr - Study guides, Class notes & Summaries

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 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...

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...

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...

HFMA CSPR EXAM QUESTIONS WITH 100% COMPLETE ANSWERS!!

CSPR 2024 UPDATE COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS (STUDY GUIDE) 2024 UPDATE GRADE A+

CSPR - Certified Specialist Payment Rep (HFMA) questions with correct answers 1. Steps used to control costs of managed care include :Answer: Bundled codes Capitation Payer and Provider to agree on reasonable payment 2. 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 3. Identify the various types of private health plan coverage:Answer: HMO Conven...

Certified Specialist Payment Rep (CSPR) HFMA 2024/25 Review-Steps used to control costs of managed care include: - Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - 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 - HMO Conventional PPO and POS HDHP/SO plans - high...

CSPR - Certified Specialist Payment Rep (HFMA) Actual Test Questions and Answers with complete solution;latest solution guide

CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+