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CSPR- CERTIFIED SPECIALIST PAYMENT REP (HFMA) 2025 2026. QUESTIONS WITH CORRECT AND VERIFIED ANSWERS. BRAND NEW!!! A+ GRADE. Steps used to control costs of managed care include: - ANSWER- Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER- Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER- HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings option; Private - Include higher patient out-of-pocket expenditures for treatments that can serve to reduce utilization/costs.
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