Rvu - Study guides, Class notes & Summaries

MS-DRGs - Medical severity diagnosis-related groups (MS-DRGs Ans: represent an inpatient prospective payment system implemented by the CMS to reimburse hospitals a predetermined amount for services provided to inpatients...can be grouped in categories called Line Graph Ans: plot is used to display time trends LOINC codes Ans: used for Identifying test results CPT codes and APC's (Ambulatory payment classifications) Ans: have a One to many relationship Frequency charts Ans: excellent...

# 1 According to the ACHE’s Code of Ethics, one way that healthcare executives can avoid or minimize the negative implications of conflict of interest is to: Make the conflict known to those in superior positions. #2 The principles of quality improvement require that healthcare executives change their management philosophy from: Finding fault with employees to finding problems in processes. #3 What type of problem arises when a healthcare executive knowingly allows the o...

FACHE - ACHE BOG EXAM SAMPLE TEST QUESTIONS - HEALTHCARE WITH COMPLETE SOLUTION Which of the following si true about a capitated Managed Care Organization (MCO) arrangement: a) The provider shifts financial risk to the MCO b) The provider can bil separately for each service provided c) The provider must wait to bil the MCO until services have been provided to a patient d) The provider is paid a set fee - ANSWER-d) The provider is paid a set fee Which of the following is a unit of me...

AAPC CPB - Chapter 11 Pre-Test Questions 2024.Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - ANSWER b. Total RVU X Conversion factor = Medicare payment ...

RBRVS - ANSWER-Resource-Based Relative Value Scale RBRVS System - ANSWER-Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - ANSWER-Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - ANSWER-1) Physician work- time, skill, training, and intensity of service provided 2) P...

BOG Practice Exam - FACHE According to the ACHE's Code of Ethics, one way that healthcare executives can avoid or minimize the negative implications of conflict of interest is to: a. Develop a public relations plan to address potential conflict-of-interest scenarios. b. Not participate in the specific decision where conflict may exist. c. Ensure members submit annual lists of major activities and holdings for inspections. d. Make the conflict known to those in superior positions. - d. M...

Inpatient Prospective Payment System (IPPS) each DC is assigned to a Medicare severity diagnosis Outpatient Prospective Payment System (OPPS) each DC is assigned to ambulatory classifications (APC) Physician fee services each service has a relative value unit (RVU) services are standardized Impact of the ACA on healthcare created new standards, individual mandates, exchanges and Medicaid expansion, focused on quality through clinical compensation, bundled payment, value-based purchasing

According to the Code of Ethics, one way executives can avoid or minimize negative implications of conflict of interest is: a) develop a PR plan to address conflict of interest scenarios b) not participate in specific decisions where conflict may exist c) ensure members submit annual holdings for inspection d) make the conflict known to those in superior positions - D The principles of quality improvement require that executives change their management philosophy from: A) finding fault w...

ACHE BOG Practice Exam 2024 REVIEW # 1 According to the ACHE’s Code of Ethics, one way that healthcare executives can avoid or minimize the negative implications of conflict of interest is to: Make the conflict known to those in superior positions. #2 The principles of quality improvement require that healthcare executives change their management philosophy from: Finding fault with employees to finding problems in processes. #3 What type of problem arises when...

The office policy for claims follow-up is to prioritize the insurance balance accounts past 90 days by highest outstanding balance. Based on the A/R report provided, which payer type and aging category would be one of the top priorities on which to focus collection efforts? - workers' compensation, 121+ days Using the fee schedule and the payment policy provided, what is the expected reimbursement (including patient responsibility) when a provider performs a nasal endoscopy and dilation of t...