Prospective payment - Study guides, Class notes & Summaries

Accident - Answer-A sudden event, unforeseen and unintended Claim - Answer-A demand for payment under the insurance policy Absolute assignment - Answer-A transfer by the policy holder of all control and rights to a third party Accident and Sickness - Answer-Insurance against bodily injury, disability or death by accident, or against disability or expense resulting from sickness, and the insurance relating thereto Accidental Means - Answer-The unexpected cause of an accidental bodily injury....

What data elements are MOST critical to the payments professional when comparing a merchant's current statement to the new offer proposed by the payment professional? - Answer- Volume, average ticket, rate, and transaction fee Using the interchange plus model, which of the following costs can be adjusted during negotiations with the merchant? - Answer- Acquirer markup For most credit card transactions, what is the MAXIMUM numbers of days between the sale and when a dispute request can be ...

Test Bank For Basic Geriatric Nursing 8th Edition by Patricia A. Williams 2023/2024 Chapter 1-20 PLUS Nclex Case Studies with Answers | All Chapters. Chapter 01: Trends and Issues Williams: Basic Geriatric Nursing 8th Edition MULTIPLE CHOICE 1. Which fact explains the shift of health care focus toward the older adult in the late 1960s? a. Disability was viewed as unavoidable. b. Complications from disease increased mortality. c. Older adults’ needs are similar to those of all adults. d....

DENTAL PUBLIC HEALTH & RESEARCH Contemporary Practice for the Dental Hygienist Fourth Edition Brief Contents UNIT I INTRODUCTION TO DENTAL PUBLIC HEALTH  1 UNIT III DENTAL HYGIENE RESEARCH  179 1 Dental Public Health: An Overview  2 14 Research in Dental Hygiene  180 2 The Prevention Movement  17 15 Ethical Principles in Research  187 3 Dental Care Delivery in the United States  34 16 The Research Process  195 4 Dental Hygiene Care Delivery in the Global Community 47 17 Biostat...

pearson vue practice exam Questions and answers, 100% Accurate, graded A+ In stating a seller's price and terms to a prospective buyer, the seller's broker is required by the law of agency to state ONLY those terms that are a. included in the listing agreement b. based on the brokers evaluation of prevailing prices and terms c. favorable for the seller, as determined by the broker d. attractive to buyers, as determined by the broker - -a. included in the listing agreement a lot measu...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

HFMA CRCR EXAM ALL 170+ QUESTIONS AND CORRECT ANSWERS GRADED A+ IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - answer -They must be billed separately to the part B Carrier what is a recurring or series registration? - answer -One registration record is created for multiple days of service What are nonemergency patients who come for servic...

CNML Test with Complete Solutions 2024/2025 DRGs - Correct Answer Diagnostic-Related Groups: payment rate based on specific diagnoses Prospective Payment System - Correct Answer Used by Medicare-participating hospitals: pretreatment diagnosis billings based on DRGs; rate decided ahead of time between insurance companies and hospitals Exclusive Provider - Correct Answer Used by HMO's: insurance coverage for contracted providers or institutions HMOs - Correct Answer Health maintenance o...

NY Series 17-52 Questions and Answers 100% Pass How many eligible employees must be included in a contributory health insurance plan? 50% A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, The insurance through his company is primary. What is the period of coverage for events such as death or divorce under COBRA? 36 months Twenty-five days after ...

HFMA CRCR EXAM ALL 170+ QUESTIONS AND CORRECT ANSWERS GRADED A+ IF outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges - answer -They must be billed separately to the part B Carrier what is a recurring or series registration? - answer -One registration record is created for multiple days of service What are nonemergency patients who come for servic...