HFMA CSPR Course 4 Comprehensive Final Exam Review Q & A 2026 (Complete And Verified Study material) (17pages) LEARNEXAMS

1. Which of the following is NOT a typical reimbursement methodology used in managed care? a) Fee-for-service b) Capitation c) Bundled payments d) Retrospective payment Answer: d) Retrospective payment Rationale: Retrospective payment is not a typical reimbursement methodology used in managed care. It involves paying providers after services have been delivered, rather than in advance or on a per-member basis. 2. In capitation, providers are paid a fixed amount per member per: a) Day b) Week c) Month d) Year Answer: c) Month Rationale: Capitation involves providers being paid a fixed amount per member per month, regardless of the services rendered. 3. Which reimbursement methodology incentivizes providers to deliver care efficiently and cost-effectively? a) Fee-for-service b) Capitation c) Bundled payments d) Retrospective payment Answer: b) Capitation Rationale: Capitation incentivizes providers to deliver care efficiently and cost-effectively, as they are paid a fixed amount per member per month regardless of the services provided. 4. Bundled payments involve paying providers a single predetermined amount for: