Postpayment review - Study guides, Class notes & Summaries

CPMA Chapter 1 Exam Prep With 100% Correct Answers 12.1% - Correct Answer-# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - Correct Answer-Fee-For-Service Prepayment Review - Correct Answer-Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - Correct Answer-Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicatin...

Medical Review Program is performed by - Macs, ZPICs/PSCs, and SMRCs Claim Review contractors identify suspected improper billing through - Error rates produced by the CERT Program, vulnerabilities identified through the Recovery Audit Program, claim data analysis, and evaluation of other information (for example, complaints). Generally, claim review contractors focus Medical Review (MR) activities on identified - problem areas and Select appropriate action for the severity of the p...

How many Major Diagnostic Categories (MDCs) are in the MS-DRG system? - 25 What is the correct CMS definition for POA indicator W - Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission The inpatient admission certification form must be signed by whom - The admitting or attending physician Which type of DRG system uses degrees of Severity of Illness and Risk of Mortality to determine the DRG? - APR-DRG Under A...

Chapter 1 CPMA Exam Prep questions and answers 100% guaranteed success. 12.1% - correct answers.# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - correct answers.Fee-For-Service Prepayment Review - correct answers.Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - correct answers.Review of claims after payment. May result in either no change to the initial d...

12.1% correct answers # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS correct answers Fee-For-Service Prepayment Review correct answers Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review correct answers Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. Underpayment correct...

12.1% # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS Fee-For-Service Prepayment Review Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. Underpayment A payment a provider receives under the amount due...

How many Major Diagnostic Categories (MDCs) are in the MS-DRG system? - 25 What is the correct CMS definition for POA indicator W - Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission The inpatient admission certification form must be signed by whom - The admitting or attending physician Which type of DRG system uses degrees of Severity of Illness and Risk of Mortality to determine the DRG? - APR-DRG Under A...

CMCA PRACTICE EXAM 136 Questions with Verified Answers The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - CORRECT ANSWER D. All the above Report cop...

CPMA Exam Prep Chapter 1 With Correct Questions And Answer 2024

Chapter 1 CPMA Exam Prep Questions with accurate answers, 100% Accurate, rated A+ 12.1% - -# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - -Fee-For-Service Prepayment Review - -Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - -Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or o...