CSPR - Questions based on full course with 100%
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Practice questions for this set
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part of prospective payment in which healthcare providers receive fixed
monthly payments for services rendered regardless of whether or not
services are used
Choose an answer
What Act shaped how commercial
insurance carriers approached the
1 2 Medicare Parts
concepts of paying for medical
care?
3 POS 4 Capitation Payment
Don't know?
Terms in this set (149)
, What Act shaped how commercial HMO Act of 1973
insurance carriers approached the
concepts of paying for medical
care?
ACA Affordable Care Act
HMO (Health Maintenance The organization is both the insurer and provider of
Organization) a set of defined services. Patients within this
network must use an in-network provider for their
services to be covered.
Capitation Payment part of prospective payment in which healthcare
providers receive fixed monthly payments for
services rendered regardless of whether or not
services are used
PPO (Preferred Provider A network of healthcare providers, such as
Organization) hospitals and physicians. They have entered into a
contract with a third-party entitled to deliver
healthcare services to individuals covered under
the plan.
POS Combines the features of both an HMO and PPO,
with costs for covered persons falling somewhere
between the two. Required to have a PCP, but can
self refer to other in-network specialists.
EPO Services are covered only if patients use doctors,
specialists or hospitals in the plan's network. There
are no out of network benefits.
ACO Accountable Care Organization
Correct Answers | Verified | Latest Update 2026
Save
Practice questions for this set
Learn 1 /7 Study using Learn
part of prospective payment in which healthcare providers receive fixed
monthly payments for services rendered regardless of whether or not
services are used
Choose an answer
What Act shaped how commercial
insurance carriers approached the
1 2 Medicare Parts
concepts of paying for medical
care?
3 POS 4 Capitation Payment
Don't know?
Terms in this set (149)
, What Act shaped how commercial HMO Act of 1973
insurance carriers approached the
concepts of paying for medical
care?
ACA Affordable Care Act
HMO (Health Maintenance The organization is both the insurer and provider of
Organization) a set of defined services. Patients within this
network must use an in-network provider for their
services to be covered.
Capitation Payment part of prospective payment in which healthcare
providers receive fixed monthly payments for
services rendered regardless of whether or not
services are used
PPO (Preferred Provider A network of healthcare providers, such as
Organization) hospitals and physicians. They have entered into a
contract with a third-party entitled to deliver
healthcare services to individuals covered under
the plan.
POS Combines the features of both an HMO and PPO,
with costs for covered persons falling somewhere
between the two. Required to have a PCP, but can
self refer to other in-network specialists.
EPO Services are covered only if patients use doctors,
specialists or hospitals in the plan's network. There
are no out of network benefits.
ACO Accountable Care Organization
