A Buck Ch16
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each of the black spaces below before clicking
on it to display the answer.
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| show | True
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| show | True
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| show | True
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| show | True
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| Kickbacks are allowed under certain circumstances | show 🗑
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| There is a "safe harbor" clause in the anti-kickback statute that protects certain types of discounting of medical services. | show 🗑
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| show | 1965
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| The Medicare Part A pays for | show 🗑
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| show | physician services and durable medical equipment
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| Who handles the day-to-day operation of the Medicare program for the CMS | show 🗑
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| show | 80 %
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| show | Direct payment is made on all clains, faster processing and a 5% higher fee schedule
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| show | ICD-9-CM, CPT, HCPCS
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| Who is the largest third-party payer in the nation | show 🗑
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| show | 1989
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| show | The relative value units for each service, a geographic adjustment factor to adjust for regional variations in the cost operating a health care facility and a national conversion factor
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| Services that are performed primarily in office settings are subject to a payment discount if they are performed in outpatient hospital departments. This is called | show 🗑
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| If a surgeon performs more than one procedure on the same patient on the same day, discounts are made on all subsequent procedures. Medicare will pay what percentages for the first, second, third and fourth procedures | show 🗑
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| Medicare sets the payment level for assistants at surgery at what percentage of the fee schedule amount for the global surgical service | show 🗑
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| show | 50%
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| What edition of the Federal Register would hospital facilit6ies be especially interested in | show 🗑
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| What edition of the Federal Register would outpatient facilities be especially interested in | show 🗑
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| What is the largest third-party payer | show 🗑
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| show | Centers for Medicare and Medicaid Services (CMS)
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| show | deductibles, premiums, and coinsurance
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| show | Yale, 1960s
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| show | New Jersey
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| What is the total number of MDCs | show 🗑
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| The creation of the PRO was made possible under a provision of what act | show 🗑
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| Which of the following is not a patient attribute for classification into a DRG | show 🗑
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| What is the name of the document that is produced by CMS that defines the type and number of health records that must be reviewed for a patient record | show 🗑
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| A complication is defined as a condition that increases the patient's length of stay in the hospital by at least 1 say in at least what percent of cases | show 🗑
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| This is not used to identify surgery unrelated to the principal diagnosis | show 🗑
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| show | Social Security Administration
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| Centers for Medicare & Medicade Services | show 🗑
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| show | PRO
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| Resource Based Relative Value Scale | show 🗑
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| Omnibus Budget Reconciliation Act | show 🗑
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| show | DRG
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| show | APG
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| Maximum Annual Allowable Charge | show 🗑
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| Relative Value Unit | show 🗑
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| Geographic Practice Cost Indiees | show 🗑
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| Prospective payment system | show 🗑
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| show | OIG
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| Department of Health & Human Services | show 🗑
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| show | accurately & completely
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| show | case mix
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| show | grouper
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| The __ program was developed by congress to monitor the necessity of hospital admissions and review the treatment costs and medical records of hospitals | show 🗑
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| The __ is a national dollar amount that is applied to all services paid on the basis of the Medicare Fee Schedule | show 🗑
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| The amount determined by multiplying the RVU weight by the geographic indes and the conversion factor is called the __ amount | show 🗑
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| For endoscopic procedures Medicare allows the full value of the highest valued endoscopy, plus the difference between the nest highest endoscopy and the __ endoscopy | show 🗑
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| List the three components of the relative value unit | show 🗑
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| show | National Medicare Fraud, Restricted Medicare Fraud
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| show | disabled, blind and those 65 years & over
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