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NEW QUESTION: 1
HOTSPOT
Answer:
Explanation:
NEW QUESTION: 2
One difference between a fee-for-service (FFS) reimbursement arrangement and capitation is that the FFS arrangement:
A. Has a potential to induce providers to underutilize medical resources, whereas capitation does 71 not have this potential disadvantage
B. Bases the amount of reimbursement on the actual medical services delivered, whereas reimbursement under capitation is independent of the actual volume and cost of services provided
C. Is most often used by health plans to reimburse healthcare facilities, whereas capitation is most often used by health plans to reimburse specialty care providers
D. Is a prospective payment system, whereas capitation is a retrospective payment system
Answer: B
NEW QUESTION: 3
If a CPL rule is not part of a policy layer, when is it processed?
A. This cannot happen. All rules must be part of a layer.
B. After all layers are processed.
C. Before any layers are processed.
Answer: B