Deal of The Day! Hurry Up, Grab the Special Discount - Save 25% - Ends In 00:00:00 Coupon code: SAVE25
Welcome to Pass4Success

- Free Preparation Discussions

AHIP AHM-530 Exam - Topic 1 Question 64 Discussion

Posted by Howard on Jan 09, 2023 at 08:02 PM

One reimbursement method that health plans can use for hospitals is the ambulatory payment classifications (APCs) method. APCs bear a resemblance to the diagnosis-related groups (DRGs) method of reimbursement. However, when comparing APCs and DRGs, one of the primary differences between the two methods is that only the APC method

Suggested Answer: B

Get Premium AHM-530 Questions as Interactive Web-Based Practice Test or PDF Real Exam Format Detailed Explanations Instant Access Get Your Practice Test
31 comments · newest first
RE
Ressie 12 months ago
APCs are retrospective? I didn't know that!
MA
Macy 1 year ago
Yup, APCs assign a single code for treatment.
BU
Buddy 1 year ago
Wait, are you sure about that? I thought DRGs covered outpatient too.
TE
Terrilyn 1 year ago
I agree, that's a key difference.
JO
Johnathon 1 year ago
APCs are definitely for outpatient care!
DE
Denise 1 year ago
I’m pretty sure DRGs cover the entire hospital stay, while APCs don’t, but I can’t recall if that makes APCs retrospective or not.
AN
Andree 1 year ago
I feel like I might confuse the codes assigned in APCs with DRGs, but I think APCs do assign a single code for treatment.
NI
Nickole 1 year ago
I remember practicing a question about APCs and DRGs, and I think the outpatient focus was a key point.
VO
Vonda 1 year ago
I think APCs are mainly for outpatient care, but I'm not entirely sure if that's the only difference from DRGs.
MA
Marshall 1 year ago
This seems straightforward - the key requirements are the ability to log and view cases, as well as track opportunities. The Partner Community license seems like the best fit.
FR
France 1 year ago
The Slow Calls and Errors tab of the application seems like the most likely place to find this information. That's where I'd expect to see details about performance issues and potential bottlenecks.
CA
Carole 1 year ago
Wasn't there a practice question about work-center utilization that pointed towards work-capacity planning? That could be relevant here.
TA
Tamesha 2 years ago
Definitely D. APCs are a retrospective payment system, meaning the hospital gets reimbursed based on the services they actually provided, not a pre-determined rate. DRGs, on the other hand, are a prospective system.
MI
Mitsue 1 year ago
↳ replying to Tamesha
DRGs, on the other hand, are a prospective system.
TU
Tu 1 year ago
↳ replying to Tamesha
C) applies to treatment received during an entire hospital stay
GE
Genevive 1 year ago
↳ replying to Tamesha
B) assigns a single code for treatment
WH
Whitney 1 year ago
↳ replying to Tamesha
That's right, hospitals are reimbursed based on the services they actually provided.
FA
Fabiola 1 year ago
↳ replying to Tamesha
I agree, APCs are definitely a retrospective payment system.
JU
Judy 1 year ago
↳ replying to Tamesha
A) is typically used for outpatient care
CH
Chana 2 years ago
Haha, I'm just imagining the coding nightmares that come with trying to use APCs for an entire hospital stay. Can you imagine the paperwork? No wonder they use DRGs instead.
CA
Carlee 1 year ago
↳ replying to Chana
C) applies to treatment received during an entire hospital stay
MI
Mitsue 2 years ago
↳ replying to Chana
A) is typically used for outpatient care
FR
Francesco 2 years ago
I'm torn between B and D. APCs assign a single code for the entire outpatient treatment, while DRGs cover the entire hospital stay. But you're right, D does seem like the most accurate answer here.
CE
Cecily 2 years ago
I think the correct answer is A. APCs are specifically used for outpatient care, while DRGs are for inpatient treatment. The question is clearly asking about the differences between the two methods.
RI
Rickie 1 year ago
↳ replying to Cecily
Exactly, APCs and DRGs have different purposes in terms of reimbursement.
JO
Jonelle 1 year ago
↳ replying to Cecily
So, the primary difference is that APCs apply to outpatient care, while DRGs are for inpatient care.
RE
Refugia 2 years ago
↳ replying to Cecily
That's correct, DRGs are for inpatient treatment.
SH
Sheridan 2 years ago
↳ replying to Cecily
I agree, APCs are indeed used for outpatient care.
BO
Bobbye 2 years ago
Hmm, that makes sense too. I can see how that would be a primary difference between APCs and DRGs.
ER
Erin 2 years ago
I disagree, I believe the answer is C) applies to treatment received during an entire hospital stay.
BO
Bobbye 2 years ago
I think the answer is A) is typically used for outpatient care.
0/2000 characters

Save Cancel