HIT 210 US Healthcare Reimbursement & Insurance Exam: Fee-for-
Service, Capitated Payments, Episode of Care, Global & Per Diem
Payments, PM-DRGs, APR-DRGs, IR-DRGs, PCGs, RBRVS, UCR, Fee
Schedules, Managed Care, Medicare, Workers’ Compensation, Third-
Party Payers, Remittance Advice, Allowable Fees, Prospective &
Retrospective Payment Methods, Financial Risk, Actuarial Pooling,
Health Maintenance Organizations (HMOs), Preferred Provider
Organizations (PPOs), Patient Claims, Reimbursement Systems, Cost
Control, Quality of Care, Fraud & Abuse, Sickness Clause, Healthcare
Accounting, and PMPM Calculations Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
All are reasons for complexity of the US Healthcare sector except for:
Straightforward language of the CFR
Employee's contributions from payroll taxes finance a portion of Medicare coverage
True
Compensation or repayment for healthcare services is known as
Reimbursement
, The level of uncertainty related to the cost of health care is the:
Degree of financial risk
It is a predetermined list of fees used by third-party payers for all healthcare services.
Fee schedule
All are forms of episode of care reimbursement except for
Fee-for-service method
Prospective payment method
Capitated payment method
Global payment method
Fee for Service
In its payment notice (remittance advice), the healthcare plan lists that the payment for the
individual laboratory test is $39.00. The bill that the pathologist's office submitted for the
laboratory test was $45.00. What does the amount of $39.00 represent?
Allowable fee
A patient saw a neurosurgeon for treatment of a nerve that was severed in an industrial
accident. The patient worked for Basic Manufacturing Company where the industrial accident
occurred. Basic Manufacturing carried workers' compensation insurance. The workers'
compensation insurance paid the fees of the neurosurgeon. Which entity is the "third-party"?
Neurosurgeon
Service, Capitated Payments, Episode of Care, Global & Per Diem
Payments, PM-DRGs, APR-DRGs, IR-DRGs, PCGs, RBRVS, UCR, Fee
Schedules, Managed Care, Medicare, Workers’ Compensation, Third-
Party Payers, Remittance Advice, Allowable Fees, Prospective &
Retrospective Payment Methods, Financial Risk, Actuarial Pooling,
Health Maintenance Organizations (HMOs), Preferred Provider
Organizations (PPOs), Patient Claims, Reimbursement Systems, Cost
Control, Quality of Care, Fraud & Abuse, Sickness Clause, Healthcare
Accounting, and PMPM Calculations Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
All are reasons for complexity of the US Healthcare sector except for:
Straightforward language of the CFR
Employee's contributions from payroll taxes finance a portion of Medicare coverage
True
Compensation or repayment for healthcare services is known as
Reimbursement
, The level of uncertainty related to the cost of health care is the:
Degree of financial risk
It is a predetermined list of fees used by third-party payers for all healthcare services.
Fee schedule
All are forms of episode of care reimbursement except for
Fee-for-service method
Prospective payment method
Capitated payment method
Global payment method
Fee for Service
In its payment notice (remittance advice), the healthcare plan lists that the payment for the
individual laboratory test is $39.00. The bill that the pathologist's office submitted for the
laboratory test was $45.00. What does the amount of $39.00 represent?
Allowable fee
A patient saw a neurosurgeon for treatment of a nerve that was severed in an industrial
accident. The patient worked for Basic Manufacturing Company where the industrial accident
occurred. Basic Manufacturing carried workers' compensation insurance. The workers'
compensation insurance paid the fees of the neurosurgeon. Which entity is the "third-party"?
Neurosurgeon
