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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. 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
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 a prospective payment system, whereas capitation is a retrospective payment system
D. Has a potential to induce providers to underutilize medical resources, whereas capitation does 71 not have this potential disadvantage
Answer: B
NEW QUESTION: 3
If a CPL rule is not part of a policy layer, when is it processed?
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B. After all layers are processed.
C. This cannot happen. All rules must be part of a layer.
Answer: B