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Ancillary charges include: Medical, surgical and central supplies.
Routine charges include: Oxygen
Which of the following is not a business office function: Discharge planning
Patient statements are generated after: RA's are posted. (Remittance Advice)
The payment method in which hospitals are paid based on the actual costs of treating each patient is: Cost-based reimbursement
Supports & shapes the body, protects the internal organs, forms some blood cells & store minerals: Skeletal System
True or False: Acute care facilities provide services for patients who do not require an overnight stay treatment: False
True or False: An Ambulatory surgery center treats in patients: False
True or False: CMS is the Abbreviation for Centers for Medicare and Medicaid Services: True
True or False: Clinics are outpatient facilities: True
True or False: The attending Physician is the doctor who is primarily responsible for the care of the patient from the hospital admission through discharge or transfer: True
True or False: The admitting physician is the doctor who is primarily responsible for the care of the patient from the hospital admission through discharge or transfer: False
CDM is the abbreviation for change description monitor: False
True or False: The charge description master is a facility's list of the codes and charges for its services: True
True or False: A charge explode occurs when the charge description master is updated each year: False
True or False: The daily coinsurance rate is equal to 75% of the inpatient hospital deductible: False
True or False: Medicare Part B pays for Coinsurance days: False
True or False: COB is the abbreviation for Coordination of benefits: True
True or False: Local Medical review policies (LMRPS) contain information about Medicare services: True
True or False: Medicare Part A Covers hospitalization but not hospice care: False
True or False: Medicare Administrative Contractors are gradually replacing fiscal Intermediaries and carriers: True
True or False: MAC is the abbreviation for Medicare Administrative Contractor: True
True or False: A modifier is a 10-digit number that can be added to CPT procedure codes: False
True or False: Unlisted procedure codes are used for new services or procedures that haven't been assigned a CPT code yet: True
True or False: HCPCS is the abbreviation for Health Care Common Product Coding System: False
True or False: The HCPCS code set has two levels, CPT codes Level I and supply codes (Level II): True
True or False: The ICD 10 CM is a listing of diagnosis codes used to classify diseases and injuries: True
Which of the following tasks is not performed by patient account specialist: Transcription of medical records.
Which type of facility provides continuous Professional Medical care for patients: Acute care facility
Which type of facility provides daily care for Inpatients who require medical care or rehabilitation services: Skilled Nursing facility
The Champva Program primarily covers: Veterans with permanent service related disabilities.
True or False: A medical EMS is a situation in which delaying treatment of the patient would lead to a significant increase in the threat to life or body part: True
True or False: In Medicare, when beneficiary who is working is covered by an employer's group health plan, the medicare secondary payer rules do not apply: False
In FL 8, which is the correct format for entering a patient's name that has a prefix, such as Van Buren: VanBuren
True or False: CORF is the abbreviation for comprehensive outpatient rehabilitation facility. True
True or False: A patient's admission date may or may not be the same as the from date in the statement covers period field. True
True or False: The purpose of a patient control number is to make locating a patient account quicker when posting payments: True
Inpatient status: 23 or more hours
Outpatient status: 23 or less
Birth day rule The parent with the earliest birthday is the primary insurance.
List the right order for Insurance, Doctor and Patient: Patient, Doctor or Provider and then Insurance
True or False: Hospital payment for a DRG is calculated by Multiplying the DRG weight by the hospital's base rate: True
Which of the following is not a level of severity: Minor CC
Number assigned to a patient that is used for multiple episodes of care at a facility: Medical Record Number
In FL 8, which is the correct format for entering a patient's name that has an apostrophe, such as O'connor: OConnor
To correctly report the dates of service in FL 6, the MMDDYY for is required. Which of the following is an example of a correct entry: 010206
True or False: A patient control number is permanently assigned to a patient and used for all episodes of care at that facility: False
The Outpatient Prospective Payment System (OPPS) is used for outpatient services including most Medicare Part B,C and D services: False
On a pater UB-04, if the patient's complete date of birth has not been obtained, FL (Patient Birth Date) should be completed with whatever information is available: False
Which payer action calls for a corrected and resubmitted claim: Claim rejection
True or False: Medicare's portion of the APC payment is equal to the APC payment amount minus the patient's coinsurance/copayment: True
True or False: The TOB code had five Digits False
True or False: A clean claim must be paid or denied by Medicare by the thirtieth day after its receipt: True
True or False: Elective Admissions are often scheduled in advance: True
True or False: The Outpatient Code editor used for Medicare Outpatient claims edits the patient's age to ensure it is consistent with the diagnosis: True
DRG Weight Reflects: How resource-intensive the DRG is relative to other DRGs
True or False: If the patient's Insurance Identifier is not the same as the insured's the patient's Insurance Identifier is entered in FL 8a: True
True or False: The date a patient is admitted for impatient care or the start of care date for home health services is called the admission date: True
True or False: TOB is the abbreviation for type of bill: True
True or False: A denied claim cannot be appealed: False
True or False: A sole community hospital is the only source of inpatient services in a given geographic area: True
True or False: An elective admission is usually a medical Emergency: False
True or False: The term working aged person in Medicare means a patient who is the age range 40-65: False
In which type of admission is the health of the patient not in jeopardy: Elective
True or False: A continuing claim is the first in a series of claims to be submitted: False
Which type of admission indicates the patient's condition is severe, life threatening, or potentially disabling: Emergency
True or False: APC is the abbreviation for Ambulatory Payment Classification: True
Which software program is used to calculate payments: Pricer
True or False:Condition Code 10 (Patient and/or spouse is employed but No EGHP Coverage Exists) is used to report that either the patient or spouse has group health Insurance: False
Condition code 18 (Maiden Name Retained) is an example of which group of condition codes: Patient condition codes
True or False: When a continuing claim is submitted, the provider expects that subsequent bills will be sent: True
True or False: CORF's are designed to provide inpatient care under a physician's supervision: False
Created by: rochelle1977