AHM-530 Exam Dumps : Network Management

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.

Cure provision

Hold-harmless provision

Evergreen clause

Exculpation clause