1. Which of the following is NOT a typical reimbursement methodology
used in managed care?
a) Fee-for-service
b) Capitation
c) Bundled payments
d) Retrospective payment
Answer: d) Retrospective payment
Rationale: Retrospective payment is not a typical reimbursement
methodology used in managed care. It involves paying providers after
services have been delivered, rather than in advance or on a per-member
basis.
2. In capitation, providers are paid a fixed amount per member per:
a) Day
b) Week
c) Month
d) Year
Answer: c) Month
Rationale: Capitation involves providers being paid a fixed amount per
member per month, regardless of the services rendered.
3. Which reimbursement methodology incentivizes providers to deliver
care efficiently and cost-effectively?
a) Fee-for-service
b) Capitation
c) Bundled payments
d) Retrospective payment
Answer: b) Capitation
Rationale: Capitation incentivizes providers to deliver care efficiently and
cost-effectively, as they are paid a fixed amount per member per month
regardless of the services provided.
4. Bundled payments involve paying providers a single predetermined
amount for:
Category | exam bundles |
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