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Terms
Question | Answer |
---|---|
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 |