Out of pocket payment Study guides, Class notes & Summaries
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CSPR - Certified Specialist Payment Rep (HFMA) questions with correct answers
- Exam (elaborations) • 29 pages • 2023
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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 s...
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 
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 
H...
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CSPR - Certified Specialist Payment Rep (HFMA) Exam 2023 with Complete Solutions
- Exam (elaborations) • 18 pages • 2023
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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...
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HFL1501 Assignment 5 (ANSWERS) Semester 1 2024 - DISTINCTION GUARANTEED
- Exam (elaborations) • 75 pages • 2024
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Well-structured HFL1501 Assignment 5 (ANSWERS) Semester 1 2024 - DISTINCTION GUARANTEED. (DETAILED ANSWERS - DISTINCTION GUARANTEED!). . Question 
1 
Not yet answered 
Marked out of 1.00 
QUIZ 
Identify whether the following statement is 
true or false 
: 
In terms of Roman legal principles, theft qualifi ed as a crime. 
Select one: 
True 
False 
Time left 
1:49:29 
UNISA 
2024 
HFL1501-24-S1 
Assessment 5 
Question 
2 
Not yet answered 
Marked out of 1.00 
QUIZ 
Consider the case o...
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Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest 2023-2024 Rated A+
- Exam (elaborations) • 11 pages • 2023
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Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest Rated A+. Which government insurance plans offers 4 different parts or areas of different 
coverage? 
A. MedicareB. Medicaid 
C. TRICARE 
D. CHAMPVA 
2. DAW/DNS stand for which of the following? 
A. Dispense as written 
B. Distribute and work 
C. Distribution and working 
D. Dispense as well 
3. Which of the following third party plans requires the patient to designate a primary care 
physician (PCP)? 
A. Health ...
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Missouri Life and Health Exam Questions and Answers 100% Pass
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Missouri Life and Health Exam Questions and Answers 100% Pass 
In a Life insurance contract, an insurance company's promise to pay stated benefits is called the: 
a) insuring clause 
b) consideration clause 
c) entire contract d) owner's rights insuring clause 
under which circumstance MUST a health insurer have an expedited grievance review procedure? when the enrollee's life or health is jeapordized 
The Consideration clause in a life insurance contract contains what pertinent information? ...
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PTCB Pharmacy Billing and Reimbursement Practice Questions and Answers Latest 2023-2024
- Exam (elaborations) • 11 pages • 2023
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PTCB Pharmacy Billing and Reimbursement Practice Questions and Answers Latest . The cost of the coverage of an insurance policy is known as which of the following? 
A. Deductible 
B. Co-payment 
C. Coinsurance 
D. Premium 
5. Which of the following is another name for the cardholder of the insurance policy? 
A. Subscriber 
B. Dependent 
Pharmacy Billing and Reimbursement 
PTCB Practice Test Questions and 
Answers Latest Rated A+ 
C. Patient 
D. Third party 
6. When a patient picks up a prescrip...
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PSI life, accident, and health Exam Questions with correct Answers
- Exam (elaborations) • 13 pages • 2022
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How long after being entitled to disability benefits will an individual be eligible to receive Medicare benefits? 
A. immediately 
B. 1 year 
C. 2 years 
D. At age 65 - ANSWER-2 years 
 
What is the return of premium rider? 
A. an increasing amount of term insurance that always equals the total of premiums paid up to the current point 
B. a provision that allows the insured to cancel the policy in the first two years and have premiums refunded 
C. an increasing amount of term insurance that e...
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CRCR Exam Prep questions and answers 2023/2024
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CRCR Exam Prep 
What are collection agency fees based on? - correct answer A percentage of dollars collected 
 
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - correct answer Birthday 
 
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - correct answer Case rates 
 
What customer service improvements might improve the patient accounts department? - correct answer Ho...
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CSPR - Certified Specialist Payment Rep (HFMA) with A+ Verified Solutions.
- Exam (elaborations) • 17 pages • 2023
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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...