CCA EXAM PREP Domain # 2 Reimbursement methodologies CORRECT
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Course
CCA
Institution
CCA
Code assignment - ANSWER 2nd step in reimbursement process
Documentation - medical/ financial record - ANSWER 1st step in reimbursement process
Claim preparation - ANSWER 3rd step in reimbursement process
Claim to payer(s) - ANSWER 4th step in reimbursement process
Claim review - ANSWER...
CCA EXAM PREP Domain # 2
Reimbursement methodologies CORRECT
100%
Code assignment - ANSWER 2nd step in reimbursement process
Documentation - medical/ financial record - ANSWER 1st step in reimbursement process
Claim preparation - ANSWER 3rd step in reimbursement process
Claim to payer(s) - ANSWER 4th step in reimbursement process
Claim review - ANSWER 5th step in reimbursement process
Claim resolution - ANSWER 6th step in reimbursement process
1. Coding for physicians
2. Coding for facilities - ANSWER What are the 2 types of outpatient coding situations
Demographic information - ANSWER What does medical biller use as foundation for determining who
should receive bills and who has responsibility for payment?
Front office during pre-regristration - ANSWER When is demographic information collected
Charge Description Master - ANSWER CDM stands for
,Charge Description Master - ANSWER List of all supplies, services, equipment, usage fees for patient care
Soft Coding - ANSWER Coders perform the coding on procedures that vary from patient to patient.
Hard coding - ANSWER Done by CDM. Automatically assigns codes based on a unique identifier number
of routine services
Fee/ Charge - ANSWER Price established and assigned to a unit of medical/ other service in facility
Annually - ANSWER How often is Chargemaster updated
Routine services - ANSWER What does chargemaster code by using the service identifier
Charge / item description - ANSWER Identifies procedure, service, product (incl. meds), other items
provided to patient
Procedure, service, product code - ANSWER CPT/ HCPCS level II codes identify specific _____ supplied to
patient. Not all ____ have corresponding CPT/ HCPCS II codes.
Revenue code - ANSWER Unique 4-digit number that represents descriptions and dollar amounts
charges for hospital services provided to patient. Must accompany valid procedure codes to be accepted
, Revenue Code - ANSWER Used to identify location in facility where procedure was performed. Must
accompany valid procedure codes to be accepted
CMS and The National Uniform Billing Committee - ANSWER Revenue codes are updated by___
Department code - ANSWER Identifies department that revenue should be allocated to for accounting
purposes.
Charge Code/ Charge description/ item code - ANSWER Each item in chargemaster is uniquely identified
by a ____ assigned by organization.
Charge status - ANSWER Active assignment of charge and can be used for tracking when and how often
an item has been charged.
Inpatient Superbill parts - ANSWER 1. Provider info
2. Patient info
3. Service info
4. Additional info
UB-04 - ANSWER What claim for are revenue codes only used for
Components for revenue codes - ANSWER 1. Demographics, incl. payer info
2. fee for each service from chargemaster
3. charge list with description
4. Correct diagnosis, procedure, supply code
Revenue Code - ANSWER 4- digit code indicates inpatient/ outpatient, department, and range of
services. Services incl. room, ancillary service.
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