After a major flu vaccination campaign, an agency bills a private insu

QUESTION

After a major flu vaccination campaign, an agency bills a private insurance company for allowable costs for administration of each vaccination according to the schedule established by the insurance company for reimbursement.

This is an example of which major payment method?

a. Cost-based reimbursement
b. Charges
c. Contractual allowance
d. Prospective reimbursement

ANSWER:

ANS: A
Because the agency is submitting costs after the campaign is completed and in accordance with an established schedule of allowable costs, a retrospective, cost-based reimbursement payment method is being utilized. If a desire for profit was indicated, then the answer would be “charges.”