NR 511 Week 1: Quiz1
The phrase usual and customary refers to:
The success rate of a specified procedure.
How much an insurer will charge to provide coverage.
Correct Answer
How charges for a service compares with charges made to other persons receiving similar services and supplies.
How ...
NR 511 Week 1: Quiz1
Question 1
pts
The phrase usual and customary refers to:
The success rate of a specified procedure.
How much an insurer will charge to provide coverage.
Correct Answer
How charges for a service compares with charges made to other persons receiving similar services and
supplies.
How an insurer evaluates the need for an ordered diagnostic test.
The phrase usual and customary refers to the comparison of charges with other like charges for services and
supplies received in the immediate vicinity as well as in a broader geographic area.
Question 2
pts
What must you do as an advanced practice registered nurse (APRN) before billing for visits?
Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer.
Provide evidence of continuing medical education
Obtain a Drug Enforcement Administration (DEA) number.
Establish a collaborative agreement with a physician.
To bill your clients for services, you must obtain a provider number and familiarize yourself with the rules and
policies of each payor.
Question 3
pts
Which one of the following is true regarding the importance of documentation?
It allows you to communicate your findings to other providers and serves as a record for the visit.
It is only important in order to bill the patient for your service.
It is only important for defending yourself in the event of a law suit.
It allows you to communicate your findings with the general public.
This study source was downloaded by 100000829878664 from CourseHero.com on 09-21-2023 02:44:44 GMT -05:00
, The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family
factors, positive and negative findings on physical exam and the provider's plan. Documentation is important
for billing purposes, communication with other providers and in the case litigation.
Question 4
pts
Which of the following statements does not belong in the past medical history portion of your chart note?
Correct Answer
Your patient had lab work done at their last appointment; CBC was normal.
Your patient’s father passed away from lung cancer.
Your patient had a cholecystectomy 3 years
prior. Your patient has an allergy to penicillin.
Allergies, family history and surgical history all belong in the history portion of your note. Test results are
objective findings and should be in the diagnostic tests (objective) section of the note.
Question 5
pts
In relation to writing a patient encounter note, the acronym SOAP stands for which of the following?
The acronym SOAP stands for subjective, objective, assessment and plan.
Question 6
pts
Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does
this mean?
The HMO reimburses the provider on a fee-for-service basis.
The HMO is not responsible for provider reimbursement.
The HMO reimburses the provider only if the patient has paid their deductible.
Correct Answer
The HMO reimburses the provider a predetermined fee per client per month based on the client’s age
and sex.
The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses
the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid,
This study source was downloaded by 100000829878664 from CourseHero.com on 09-21-2023 02:44:44 GMT -05:00
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