WGU C428 Exam Questions and Answers| ALREADY PASSED | LATEST
UPDATE
,The 4 C's (Finance Activities) ------✔✔*Costs >monitor costs
*Cash------ >keep enough cash
*Capital------>raise needed capital(money) to invest
*Control---->control resources
Accountable Care Organization ✔✔Accountable Care Organizations(ACOs) are groups of
Medicare providers and suppliers that work together to coordinate care for traditional
Medicare patients.
Their goal is to deliver seamless, high-quality care instead of the fragmented care that
often results from a fee-for-service payment system.
The following group of providers can form an ACO: physicians or certain non-physician
practitioners in group practices, hospitals employing physicians, certain critical access
hospitals, federally qualified health centers, and rural health clinics
Beneficiary ✔✔Insurers usually refer to the patient for which services are paid as
the beneficiary
Benefit payment ✔✔Once the insurer has determined the claim is appropriate, a payment
is made to the provider. This payment is officially termed a benefit payment
Bundled payments ✔✔A bundled payment is a single prospective payment by a health plan
to all providers involved in a patients episode of care where the providers divide the
payment among themselves
, Centers for Medicare and Medicaid Services (CMS) ✔✔The federal government, through the
Centers for Medicare and Medicaid Services or CMS, oversees all parts of the Medicare and
Medicaid programs. CMS can waive a state's requirement to participate in traditional
Medicaid if the state offers beneficiaries plans with better benefits.
UPDATE
,The 4 C's (Finance Activities) ------✔✔*Costs >monitor costs
*Cash------ >keep enough cash
*Capital------>raise needed capital(money) to invest
*Control---->control resources
Accountable Care Organization ✔✔Accountable Care Organizations(ACOs) are groups of
Medicare providers and suppliers that work together to coordinate care for traditional
Medicare patients.
Their goal is to deliver seamless, high-quality care instead of the fragmented care that
often results from a fee-for-service payment system.
The following group of providers can form an ACO: physicians or certain non-physician
practitioners in group practices, hospitals employing physicians, certain critical access
hospitals, federally qualified health centers, and rural health clinics
Beneficiary ✔✔Insurers usually refer to the patient for which services are paid as
the beneficiary
Benefit payment ✔✔Once the insurer has determined the claim is appropriate, a payment
is made to the provider. This payment is officially termed a benefit payment
Bundled payments ✔✔A bundled payment is a single prospective payment by a health plan
to all providers involved in a patients episode of care where the providers divide the
payment among themselves
, Centers for Medicare and Medicaid Services (CMS) ✔✔The federal government, through the
Centers for Medicare and Medicaid Services or CMS, oversees all parts of the Medicare and
Medicaid programs. CMS can waive a state's requirement to participate in traditional
Medicaid if the state offers beneficiaries plans with better benefits.
