AHM-530 Exam Dumps : Network Management

workers' compensation coverage is available to all employees, regardless of their eligibility for health insurance coverage

indemnity benefits currently account for less than 10% of all workers' compensation benefits

workers' compensation programs in most states require eligible employees to obtain medical treatment only from members of a provider network

workers' compensation programs include deductibles and coinsurance requirements

Made for services rendered to specific patients

Made with matching state and federal funds

Included in the Medicaid capitation payment made to patients’ health plans

Defined as cost-based reimbursement (CBR) equal to 100% of Portway’s reasonable costs of providing services to Medicaid recipients

A discounted fee-for-service (DFFS) system is usually easier for a health plan to administer than is a fee schedule system.

A case rate payment system offers providers an incentive to take an active role in managing cost and utilization.

One reason that health plans use a relative value scale (RVS) payment system is that RVS values for cognitive services have traditionally been higher than the values for procedural services.

One reason that health plans use a resource-based relative value scale (RBRVS) is that this system includes weighted unit values for all types of procedures.