Author Question: In the managed care industry, there are specific reimbursement concepts, such as capitation. All of ... (Read 50 times)

joesmith1212 · **on:** Jun 27, 2018

In the managed care industry, there are specific reimbursement concepts, such as capitation. All
of the following statements are true in regard to the concept of capitation, EXCEPT
A. each service is paid based on the actual charges.
B. the volume of services and their expense do not affect reimbursement.
C. capitation means paying a fixed amount per member per month.
D. capitation involves a group of physicians or an individual physician.

Question 2

Which code represents a new patient exam in which the physician documents a detailed history, detailed examination, and medical decision making of low complexity?
a. 99203
b. 99204
c. 99213
d. 99214