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Healthcare Reimbursement -Study guide
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Accountable care organization - correct answer Population based model for healthcare allowable charge - correct answer Amount the payer will reimburse providers for the service Attribution - correct answer Assignment of a beneficiary to particular organization Billed charges - correct answer Amount the provider is actually charging for a service Giant ACO has agreed to a shared savings rate of 65 percent and a shared loss rate of 40 percent with CMS. Giant ACO participates in a __________ risk agreement. - correct answer Two-sided In the CMS ACO model, what is attribution? - correct answer A beneficiary is assigned to a particular ACO. In the CMS-HCC model, beneficiaries with a risk score greater than 1 have ___________? - correct
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