CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) REAL EXAM AND STUDY GUIDE

CSPR - CERTIFIED SPECIALIST PAYMENT REP (HFMA) REAL EXAM AND STUDY GUIDE Which option is considered a key difference between inpatient and outpatient contracting? - Correct Answer -Reimbursement methodology differences -Operational policies and procedures -Market differences affecting outpatient and inpatient volumes All of the following should be analyzed prior to and/or during contract negotiations, EXCEPT: - Correct Answer Historical member premiums All of the following should be analyzed prior to and/or during contract negotiations: - Correct Answer -Member volumes by product type -Historical reimbursement levels by product type -Historical claims payment and/or submission problems Steps used to control costs of managed care include: - Correct Answer Bundled codes Capitation Payer and Provider to agree on reasonable payment