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Bill 2

QuestionAnswer
Accreditation Voluntary process that a health care facility or organization undergoes to demonstrate that it has met standards beyond those required by law
Advanced Alternative Payment Models (advanced APMs) Include New ways for CMS to reimburse health care proviers for care provided to Medicare beneficiaries; providers who participate in an Advanced APM through Medicare B may earn inc paym for particpating in the innovative Payment Model
Alternative Payment Models APMs Include new ways for CMS to remimburse health care providers for care provided to Medicare beneficiaries; providers who participate in Advance APM through Med Prt B may earn an incentive payment for participating in the innovative payment model
Benchmarking Practice that allows an entity to measure and compare its own data against that of other agencies and organizations for the purpose of continuous improvement eg coding error rates
Cafeteria Plan Also called triple option plan provides different health benefit plans and extra coverage options through an insurer or third party administrator
capitation Prospective payment per patient for a prescribed period of time provider accepts pre-established payments for providing health care services to enrolled members over a specified period of time usually one year or monthly
Carve-out arrangement Allows certain health care benefits to be managed separately from the health plan at an additional cost. eg dental services
case Manager submits written confirmation authorizing treatment to the provider include nurses and social workers who help pts and families navigate complex health care and support systems also coordinate health care while considering fin implicati as part of sever
Created by: luci2
 

 



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