Rvu - Study guides, Class notes & Summaries

RVU The Respiratory System with Complete Solution / latest update 2024 | 2025

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 Correct Answer: D The principles of quality improvement require that executives change their management philosophy from: A...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

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 - ANS b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the ...

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 measure commonly used to determine provider productivity? a) RVU b) CMS c) IPA ...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

CHDA Study Guide Questions and Answers 100% Solved HOPPS ️️Hospital Outpatient Prospective Payment System HEDIS ️️Healthcare Effectiveness Data and Information Set OASIS ️️Outcome and Assessment Information Set ORYX ️️ UHDDS ️️Uniform Hospital Discharge Data Set AJCC ️️American Joint Committee on Cancer HIE ️️Health Informatrion Exchange RVU ️️Relative Value Unit peRVU ️️Practive expense RVU

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 - d) The provider is paid a set fee Which of the following is a unit of measure commonly used to determine provider productivity? a) RVU b) CMS c) IPA d) TJC - a) RV...

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...

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 - b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the following ...