Health Insurance Chapter 9
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| show | ambulatory surgicval center (ASC)
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| show | clinical laboratory fee schedule
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| show | (1) submitted charge, or(2) national limitation amount, or(3) local fee schedule amount, whichever is lowest.
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| show | durable medical equipment, prosthetics/orthotics, and supplies (DMEPOS)
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| show | home health resource groups (HHRGs).
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| This is used to determine the appropriate HHRG after Outcomes and Assessment Information Set (OASIS) is input on each patient (to measure the outcome of all adult patients receiving home health services). | show 🗑
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| This data entry software is used to collect OASIS assessment data for transmission to state databases. | show 🗑
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| show | major diagnositc categories (MDCs)
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| Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG, and the reimbursement rate can be adjusted according to the following guidelines: | show 🗑
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| The Inpatient Prospective Payment System (IPPS) uses a payment system called __________ to classify patients into one of 745 groups. | show 🗑
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| show | present on admission (POA)
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| The outpatient prospective payment system (OPPS) for hospital outpatient services provided to Medicare patients are paid according to ____________ which group services according to similar clinical characteristics and in terms of resources required. | show 🗑
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| This adjusts payments to account for geographic variations in hospitals' labor costs. | show 🗑
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| A skilled nursing facility (SNF) per diem payments are case-mix adjusted using a resident classification system called _____________ based on data from resident assessments and relative weights developed from staff time data. Cost-based. | show 🗑
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| Physician services are reimbursed according to a payment system called Resource based relative value system (RBRVS) also called the Medicare physican fee schedule. All services are assigned relative value units (RVUs) consisting of what? | show 🗑
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| Services provided by nonphysician practitioners may also be reported to Medicare as _____________to the supervising physician's service and are reimbursed at 100 percent of the Medicare physician fee schedule. | show 🗑
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| The Resource-Based Relative Value Scale (RBRVS) is now called the ______________ | show 🗑
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| In the MS-DRG system, some DRGs have been further refined by what? | show 🗑
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Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
ljlindrose61