Beginner Exercises Term Explained for Students (Easy Guide)

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Beginner Exercises 1. Key Term Matching (Level 1—Remembering) Associate-level Competency: IV.2. Describe components of revenue cycle management and clinical documentation improvement. Baccalaureate-level Competency: IV.2. Manage components of the revenue cycle. Match the key term to the correct definition. Key Term Answer Definition a. Accountable care organization Risk adjustment model that uses patient demographic characteristics and medical conditions to predict the patient’s healthcare costs. b. Allowable charge Amount the provider is actually charging for a service c. Attribution Type of risk used in ACO payment methodology where the ACO must share in the loss if the cost of care for their attributed beneficiaries is greater than the benchmark as well as any savings if the cost of care is lower than the benchmark. d. Billed charges Type of risk used in ACO payment methodology where the ACO shares in any savings generated by the organization but does not share in the losses. e. CMS-HCC Model Statistical process that considers the underlying health status and health spending of patients when examining their health outcomes or healthcare costs f. One-sided risk Amount the payer will reimburse providers for the service g. Payment Assignment of a beneficiary to a particular organization h. Risk adjustment

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