CCA Exam Prep Domain 2()Questions And Answers 100% Correct!

Allowable fee - ANSWERAverage or maximum amount the third-party payer will reimburse providers for the service Block grant - ANSWERIt is a fixed amount of money given or allocated for a specific purpose. Ex. Medicare's payment system for home health services are consolidated into the single payment Capitated payment method - ANSWERIt is a method of payment for health services in which the third-party payer reimburses providers a fixed, per capita amount for a period. "Per capita" means "per head" Case-based payment - ANSWERType of prospective payment method in which the third-party payer reimburses the provider a fixed, preestablished payment for each case Adjacent episodes of care - ANSWEREpisodes of home health that are contiguous and separated by no more than 6 days Adjudication - ANSWERThe determination of the reimbursement payment based upon the member's insurance benefits Adverse selection - ANSWEREnrollment of excessive proportion of persons with poor health status in a healthcare plan or healthcare organization RBRVS - ANSWERThe federal government's payment system for physicians. It is a system of classifying health services based on the cost of furnishing physicians' services in different settings, the skill and training levels required to perform the services, and the time and risk involved