Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

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Study for the Adult-Gerontology Clinical Nurse Specialist Exam. Prepare with flashcards and multiple-choice questions, each with hints and explanations. Get ready for your exam!

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When charges are billed based on individual services provided, this is known as which payment system?

Prospective payment system
Single payer system
Retrospective payment system
Third-party payer system

The correct answer is: Retrospective payment system

When charges are billed based on individual services provided, this refers to a payment system that is characterized by the reimbursement occurring after the services have been rendered. In this model, providers bill for each service rendered at the actual cost, which allows for payments to vary based on the volume and type of services delivered to patients. The retrospective payment system thus reflects this post-service billing approach, where insurance plans or payers assess the services after they have been provided and reimburse accordingly. This system can lead to variations in the amount paid for similar services due to the differences in what each provider bills or the complexity of the services rendered. In contrast, other payment systems, such as prospective payment systems, provide a predetermined payment amount for services, regardless of the actual costs incurred during treatment. Understanding the nuances of these systems is crucial for effective financial management in healthcare settings.