Final exam cms review Study guides, Class notes & Summaries

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

COC 2020 - FINAL EXAM QUESTIONS W/O CODES (SET 6) | Questions with 100% Correct Answers | Latest Update 2024 | Verified Which service is reimbursed based on the APC payment method? - Patient X-ray of left foot in the outpatient department Rationale: The APC system is a payment methodology for outpatient, or ambulatory, facility services. It does not include the professional component of ambulatory care, which is paid under the Resource-Based Relative Value Scale (RBRVS) methodology. Also ...

Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reportin...

CMCA PRACTICE EXAM 136 Questions with Verified Answers The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - CORRECT ANSWER D. All the above Report cop...

CCS Practice Exam Questions And Answers Latest Update 2024 (GRADED) A 12-year-old boy was seen in an ambulatory surgical center for pain in his right arm. The x-ray showed fracture of ulna. Patient underwent closed reduction of fracture right proximal ulna and an elbow-to-finger cast was applied. What diagnostic and procedure codes should be assigned? S52.101AUnspecified fracture of upper end of right radius, initial encounter for closed fracture S52.101BUnspecified fracture of upper end o...

NCCT Practice Test Exam Questions and Answers Latest 2024/2025 (100% Correct) Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? a. "Do you have any questions about the cost of today's visit?" b. We can accept your insurance as payment in full." c. "Do you know what your out of pocket cost is today?" d. "We will bill you for the visit in full." - A. "Do you have any questions about the cost of today's visit?" Which of...

Leadership Final Exam Questions With Verified Answers Advanced Practice Registered Nurse (APRN) - answerA group of nurses, prepared at the graduate level, with defined roles and scopes who function in expanded nursing roles. Those roles are: certified registered nurse anesthetists, certified nurse-midwives, clinical nurse specialists, and certified nurse practitioners. Clinical Processes - answerA defined sequence of steps needed to ensure that basic functions are fulfilled in a standardi...

CPCS Exam 2023 Questions and Answers Rated A+ TJC (The Joint Commission) Definition of Credentialing The process of obtaining, verifying, and assessing the qualifications of a health care practitioner who seeks to provide patient care services in or for a hospital. NCQA (National Committee for Quality Assurance) definition of credentialing process by which an organization reviews and evaluates qualifications of licensed independent practitioners to provide services to its members. Should you u...

CDIP Final Exam Questions With Complete Solutions 2023/2024 (Latest Graded A+). The appeal coordinator received a denial that stated: On presentation, patient had hemoglobin of 8.8 with blood in stool noted in physician office...patient sent as direct admission straight to hospital. The physician notes 11/05/14 states GI bleeding will consider transfusion 11/06/14. Note also states melenic stools and states hemoccult positive. Endoscopy report states - Acute Posthemorrhagic Anemia with iron...

NCCT Practice Test Exam Questions and Answers Latest (100% Solved) Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? a. "Do you have any questions about the cost of today's visit?" b. We can accept your insurance as payment in full." c. "Do you know what your out of pocket cost is today?" d. "We will bill you for the visit in full." - A. "Do you have any questions about the cost of today's visit?" Which of the follo...