A Buck Ch16
Quiz yourself by thinking what should be in
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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Nationally unit values have been assigned for each service (CPT), and they are determined on the basis of the resources necessary to the physician's performance of the service | show 🗑
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show | True
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show | False
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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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show | hospital/facility care
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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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Medicare pays for what percentage of covered charges | show 🗑
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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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A major change took place in Medicare in __ with the enactment of the Omnibus Budget Reconciliation Act | show 🗑
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The physician fee schedule is updated each April 15 and is composed of | show 🗑
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show | Site of Service limitations
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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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show | 16%
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When an unlisted procedure is billed because no other code exists to describe the treatment, payment is based on a mazimym of this percentage of the value of the intraoperation services originally performed | show 🗑
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show | October
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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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What government organization is responsible for administering the Medicare program | show 🗑
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What are the three items that the Medicare beneficiaries are responsible to pay before Medicare will begin to pay for services | show 🗑
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Where and when were the DRGs first developed | show 🗑
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What was the state that first used the DRGs on a large scale | show 🗑
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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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show | length of stay
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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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show | 75%
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show | 482
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show | Social Security Administration
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Centers for Medicare & Medicade Services | show 🗑
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Peer Review Organization | show 🗑
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show | RBRVS
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show | OBRA
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show | DRG
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Ambulatory Patient Groups | show 🗑
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show | MAAC
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show | RVU
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show | GPCI
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show | PPS
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show | OIG
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show | DHHS
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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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show | base
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List the three components of the relative value unit | show 🗑
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Name the two types of fraud alerts | show 🗑
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show | disabled, blind and those 65 years & over
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