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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.
        Help!  

Question
Answer
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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