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Examen
CERTIFIED SPECIALIST PAYMENT REP (HFMA) 2025 ACTUAL EXAM COMPREHENSIVE QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) /ALREADY GRADED A+
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---26mayo 20252024/2025A+
- Steps used to control costs of managed care include: - ANSWER Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
DRG is used to classify - ANSWER Inpatient admissions for the purpose of reimbursing hospitals 
for each case in a given category w/a negotiated fixed fee, regardless of the actual costs 
incurred 
Identify the various types of private health plan coverage - ANSWER HMO 
Conventional 
PPO and POS 
HDHP/SO plans - high-deductible health plans with a savings...
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