Health Insurance Word Scramble
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Question | Answer |
What is the payment system for Outpatient PPS? | APC-Ambulatory Payment Classification |
What is the payment system for Inpatient PPS? | MS DRG's-Medicare Severity Diagnosis Related Groups |
What is the payment system for Skilled Nursing Facilities? | RUG-Resource Utilization Group |
Name the adjustments that qualifying hospitals can receive under the IPPS. | DSH, Outlier, and IME |
What is a state-licensed, Medicare certified supplier of surgical healthcare services that must accept assignment on claims? | ASC-Ambulatory Surgical Center |
What are MS DRGs organized into? | MDC-Major Diagnostic Categories |
What is it called when NPP's can bill services provided to Medicare beneficiaries to Medicare directly, which means their services are billed under a supervising physician? | Incident To |
In the Inpatient PPS, what is assigned to each diagnosis to differentiate between conditions present on admission and those that develop during the hospital stay? | POA-Present on Admission |
How does Medicare reimburse laboratory services? | Either on submitted charge, national limitation amount, or local fee schedule amount, whichever is lowest. |
How does Medicare reimburse DMEPOS? | Either 80% of the actual charge amount or the fee schedule amount, whichever is lowest. |
Medicare reimburses physician's services based on Relative Value Units assigned to each service/procedure. What does this consist of? | Physician work expense, practice expense, and malpractice expense (malpractice insurance expense). |
What are the patient assessments used in Home Health PPS? | OASIS-Outcomes and Assessments Information Sets |
What does Medicare call the EOB? | MSN-Medicare Summary Notice |
What is the process by which healthcare facilities and providers ensure their financial viability by increasing revenue, improving cash flow, and enhancing the patient's experience? | Revenue Cycle Management |
Created by:
YTIMBC
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