AHIP Exam AHM-530 Topic 1 Question 64 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 64
Topic #: 1

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

Ais typically used for outpatient care

Bassigns a single code for treatment

Capplies to treatment received during an entire hospital stay

Dis considered to be a retrospective payment system

Show Suggested Answer

Suggested Answer: B

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

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Tamesha

2 months 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.

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Mitsue

10 days ago

DRGs, on the other hand, are a prospective system.

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Tu

13 days ago

C) applies to treatment received during an entire hospital stay

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Genevive

24 days ago

B) assigns a single code for treatment

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Whitney

24 days ago

That's right, hospitals are reimbursed based on the services they actually provided.

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Fabiola

30 days ago

I agree, APCs are definitely a retrospective payment system.

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Judy

1 months ago

A) is typically used for outpatient care

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Chana

2 months 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.

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Carlee

1 months ago

C) applies to treatment received during an entire hospital stay

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Mitsue

2 months ago

A) is typically used for outpatient care

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Francesco

2 months 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.

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Cecily

2 months 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.

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