AAHAM TESTS COMPILATION BUNDLE

Identify federal agencies playing a major role in healthcare correct answer: Department of Health and Human Services (BHHS) and Centers for Medicare and Medicaid Services (CMS) General provisions of major federal regulations correct answer: Patient rights, Affordable care, Anti-Fraud and abuse,...

The billing form for hospital claims correct answer: UB04 (CMS 1450 & 8371) Lifetime reserve amounts are calculated based on a per day allowance at: correct answer: 50% of the Medicare Part A deductible What is the coinsurance amount for days 1-20 for SNF care? correct answer: $0.00 A cl...

What are the Federal Agencies that are part of the U.S. Department of Health and Human Services (HHS)? correct answer: Centers of Medicare & Medicaid Services (CMS) Office of Inspector General (OIG) What are the HHS Operating Divisions? correct answer: National Institutes of Health (NIH) Food...

APC correct answer: ambulatory payment classification; a payment methodology in which services paid under the prospective payment system are classified into groups that are similar clincially and in terms of the resources they require; a payment rate is est. for each APC APR correct answer: ann...

Which collection points are the patient most likely to pay during? correct answer: Pre-admission and admission 5 collection control points correct answer: -admission sion -house discharge discharge Which percentage should be pre-registered within 24 hours of service date? correct answ...

Bad debt correct answer: Uncollectible account resulting from the extension of credit Indigent correct answer: An individual with no means of paying for services or treatments, who is not legible for Medicaid or another public assistance program LIEN correct answer: I recorded claim against...

NCDS correct answer: Medical review policies that identify specific medical item/services/treatment procedures/technologies Definitive dx for LCD/NCD correct answer: Discusses & lists specific dx codes, ICD Procedure codes & possibly signs/symptoms to support the need for the item/service being...

AABB correct answer: American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse correct answer: Improperly, and often unknowingly, violating regulations ALJ hearing correct answer: The third level of Medicare appeal; the amount in controversy threshold f...

Also known as the Kennedy-Kassenbaum bill correct answer: HIPAA Provides that a reported error must be corrected or explained within 2 billing cycles or 90 days correct answer: Fair Credit Billing Act Formerly known as HCFA correct answer: CMS Also known as Regulation Z correct answer: ...

beneficiary correct answer: person who has healthcare insurance through Medicare Referring Physician correct answer: A physician who requests an item or service for a beneficiary for which payment will be made under Medicare Ordering Physician correct answer: A physician who order non physi...

3-Day Rule correct answer: Medicare regulation requiring that certain outpatient services within 72 hours of an inpatient admission must be included in the patient's inpatient claim and reimbursed under a DRG. 8371 correct answer: HIPAA standard transaction used by hospitals to submit claims e...

Also known as the Kennedy kassenbaum bill correct answer: HIPAA Providers that a reporter error must be corrected or explained within 2 billing cycles or 90 days correct answer: Fair credit billing act Formerly known as HCFA correct answer: CMS Also known as regulation Z correct answer: ...

1-day payment window rule correct answer: a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule correct answer:...

The name and acronym for the government's largest grant making agency correct answer: Department of Health and Human Services (DHHS) Medicare is also known as Title *BLANK* of CMS correct answer: XVII (18) Medicaid is also known as Title *BLANK* of CMS correct answer: XIX (19) The progr...