Facility practice rvu - Study guides, Class notes & Summaries

Modifiers - provide addtional info about the service/procedure indicating service/procedure has been altered but the definition of the code has not changed. Global Surgery Package - The time, effort, and services required to complete a procedure are bundled together to form a surgery package . Payment is made for a package of services and not each individual service provided within the package. Using RBRVS - CMS annually publishes Physician Fee Schedule information on its website and posts...

AAPC Official CPC Certification Study Guide Notes "Hold harmless clause" - answer* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - answer* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing house is a - answer...

AAPC Official CPC Certification Study Guide Notes "hold harmless clause" - Answer ️️ -* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - Answer ️️ -* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing h...

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...

AAPC Official CPC Certification Study Guide Notes "Hold harmless clause" - answer* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - answer* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing house is a - answer...

CPB Practice Exam A 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 ...

AAPC Official CPC Certification Study Guide Notes "hold harmless clause" - Answer ️️ -* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - Answer ️️ -* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing h...

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...

"hold harmless clause" - Answer * found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - Answer * more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing house is a - Answer entity that processes nonstandard health infor...

________ is when the provider has limited access to payer and patient data elements on their patients only. - Extranet An extranet is a private computer network allowing controlled access to the payer's system. The provider has limited access to payer and patient data elements on their patients only. 1992 US federal government implemented a standardized physician payment schedule utilizing resourcebased relative value scale - RBRVS A batch of claims is submitted to the clearinghouse for pr...