CCA Exam Prep Domain 2.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CCA%20Exam%
CCA Exam Prep Domain 2 Questions &
Answers
1. Allowable fee
Answer Average or maximum amount the third-party payer will reimburseproviders
for the service
2. Block grant
Answer It is a fixed amount of money given or allocated for a specific purpose. Ex.
Medicare's payment system for home health services are consolidatedinto the single
payment
3. Capitated payment method
Answer It is a method of payment for health services inwhich the third-party
payer reimburses providers a fixed, per capita amount for aperiod. "Per capita"
means "per head"
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,CCA Exam Prep Domain 2.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CCA%20Exam%
4. Case-based payment
Answer Type of prospective payment method in which the
third-party payer reimburses the provider a fixed, preestablished payment for each
case
5. Adjacent episodes of care
Answer Episodes of home health that are contiguous andseparated by no more
than 6 days
6. Adjudication
Answer The determination of the reimbursement payment based upon themember's
insurance benefits
7. Adverse selection
Answer Enrollment of excessive proportion of persons with poorhealth status in
a healthcare plan or healthcare organization
8. RBRVS
Answer The federal government's payment system for physicians. It is a systemof
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CCA Exam Prep Domain 2 Questions &
Answers
1. Allowable fee
Answer Average or maximum amount the third-party payer will reimburseproviders
for the service
2. Block grant
Answer It is a fixed amount of money given or allocated for a specific purpose. Ex.
Medicare's payment system for home health services are consolidatedinto the single
payment
3. Capitated payment method
Answer It is a method of payment for health services inwhich the third-party
payer reimburses providers a fixed, per capita amount for aperiod. "Per capita"
means "per head"
1/4
1 of 12 12/10/2024, 11:32
,CCA Exam Prep Domain 2.pdf file:///C:/Users/HP/Desktop/New%20folder%20(2)/CCA%20Exam%
4. Case-based payment
Answer Type of prospective payment method in which the
third-party payer reimburses the provider a fixed, preestablished payment for each
case
5. Adjacent episodes of care
Answer Episodes of home health that are contiguous andseparated by no more
than 6 days
6. Adjudication
Answer The determination of the reimbursement payment based upon themember's
insurance benefits
7. Adverse selection
Answer Enrollment of excessive proportion of persons with poorhealth status in
a healthcare plan or healthcare organization
8. RBRVS
Answer The federal government's payment system for physicians. It is a systemof
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2 of 12 12/10/2024, 11:32
