Certified Medical Administrative Assistants (CMAA) Practice Exam 2025 - Free CMAA Practice Questions and Study Guide

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What does it mean to be enrolled in capitation?

Receiving variable payments based on services provided

Getting a fixed amount for each patient regardless of care needed

Being enrolled in capitation means that a healthcare provider is compensated with a fixed amount for each patient assigned to them, regardless of the actual care required or delivered. This payment model incentivizes providers to manage the healthcare of their patient population effectively and efficiently since the payment does not fluctuate based on the volume of services provided.

In capitation, the predictable revenue stream can lead to better budget management for providers, as they receive a steady income to cover the costs of care for enrolled patients. It contrasts with fee-for-service models, where providers are paid based on the quantity of services rendered, which can lead to overutilization of services.

The other options describe different aspects of healthcare financing or specific arrangements that do not pertain to the definition of capitation. For instance, receiving variable payments based on services provided refers more to a fee-for-service model and is not consistent with the fixed nature of capitation. Gaining patient consent for every service provided does not directly relate to payment models, and having an insurance policy that only covers inpatient services relates to the scope of coverage, not the payment structure for providers.

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Having to gain patient consent for every service given

Having an insurance policy that covers inpatient services only

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