Primary payer - Study guides, Class notes & Summaries

Medical Assisting Administrative & Clinical Competencies (MindTap Course List) 9th Edition 1 | P a g e TEST BANK FOR Medical Assisting Administrative & Clinical Competencies (MindTap Course List) 9thEdition Chapter 1 1. Medical assisting is probably right for you if you: a. like to work alone, completing tasks independently. b. are more comfortable completing a consistent task daily. c. do not like variety in your job. d. are interested in a career in an expanding field. ANSWER: d PO...

Nursing Facilities AKA - correct answer Nursing homes (both) skilled nursing facilities (medicare) (SNF) Intermediate care facilities (medicaid) Nursing Facilities - correct answer Provide a broad range of personal, social, and medical services to assist people with functional or cognitive limitations What type of nursing facilities are available? - correct answer ...

Through what document does a hospital establish compliance standards? code of conduct What is the purpose OIG work plant? Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without chan...

CRCR Exam Prep What are collection agency fees based on? - correct answer A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - correct answer Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - correct answer Case rates What customer service improvements might improve the patient accounts department? - correct answer Ho...

Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n) Answers>>Guaranteed insurability rider A guaranteed insurability rider allows for the insured to purchase additional insurance at specific dates or events without evidence of insurability. Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered Answers&...

A set of standards that provides universal names and codes for laboratory and clinical results is . Answer - Logical Observation Identifiers Names and Codes (LOINC) High-quality information is contingent on . a. Computerized decision support b. Systems integration c. Knowledge management d. Reliable data Answer - d. Reliable data The individual most likely to lead strategic planning for a healthcare organization's information system is the . a. CEO b. HIM director c. CIO d. Medical ...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - CORRECT ANSWER National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? - CORRECT ANSWER Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - CORRECT ANSWER Agin...

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED What are collection agency fees based on? - CORRECT ANSWER-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER-Case rates What customer service improvements might improve the patie...

Answers Olds Maternal Newborn Nursing and Womens Health Across the Lifespan 11th Edition Davidson Test Bank TEST BANK: OLDS’ MATERNALNEWBORNNURSING & WOMEN’S HEALTH ACROSS THE LIFESPAN, 11TH EDITION, MICHELE DAVIDSON, MARCIA LONDON, PATRICIA LADEWIG Table of Contents PART I: INTRODUCTION TO MATERNAL-NEWBORN NURSING 1. Contemporary Maternal-Newborn Nursing 2. Families, Cultures, and Complementary Therapies PART II: WOMEN’S HEALTH ACROSS THE LIFESPAN 3. Health Promotion 4. Fa...

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...