Rhia domain 4 - Study guides, Class notes & Summaries

RHIA Domain 4 Exam Questions with Correct Answers Which government-sponsored program provides coverage for active-duty service members of the armed forces (ADSM)? - Answer-TRICARE Dr. McGee is a primary care physician. Several of Dr. McGee's patients are insured by Super Payer. Super Payer reimburses Dr. McGee for each service she provides during a clinic visit. Which reimbursement methodology does Super Payer use to reimburse Dr. McGee? - Answer-Fee schedule Dayna is analyst at Communit...

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RHIA Domain 4 Study Test Questions with Answers A CDI program facilitates accurate coding & helps coders avoid: A. NCCI edits B. Upcoding C. Coding without a complete face sheet D. Assumption coding - Answer-D. Assumption coding Which of the following is a governmental designation by the state that is necessary for the facility to offer services? A. Survey B. Licensure C. Certification D. Accreditation - Answer-B. Licensure Reviewing claims to ensure appropriate coding ...

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Medicare Prescription Drug Plan: covers the cost of prescription drugs. Deductibles, cost, and coverage vary; the beneficiary pays a monthly premium, a deductible, and part of the cost of the drug. - Answer Medicare Part D __________ is a joint program of the federal and state government that provides health care for individuals who receive welfare, low-income pregnant women, and poor children. Each state determines qualification criteria, such as income levels, but the state must comply w...

The conversion factor is the national dollar multiplier that sets the allowance for the relative values—a constant (Casto and Forrestal 2013, 157). A Joint Commission accredited organization must review their formulary annually to ensure a medications continued: - Answer efficacy and safety Part of the coding supervisor's responsibility is to review accounts that have not been final billed due to errors. One of the accounts on the list is a same-day procedure. Upon review, the coding su...

In the APC system, a high-cost outlier payment is paid when which of the following occurs? a. The cost of the service is greater than the APC payment by a fixed ratio and exceeds the APC payment plus a threshold amount. b. The LOS is greater than expected. c. The charges for the services provided are greater than the expected payment. d. The total cost of all the services is greater than the sum of APC payments by a fixed ratio and exceeds the sum of APC payments plus a threshold amount. ...

what is the limiting charge amount? - Answer 115 The limiting charge does not apply to: (3) - Answer immunizations, supplies, or ambulance services Two main types of coverage plans in Medicare - Answer fee-for-service or managed care The Medicare fee-for-service plan - Answer Original Medicare Plan

RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified

Preliminary Step in Strategy Planning - Answer Conduct an internal environment assessment Graph Analysis - Answer Can only look at numbers, don't put in analysis for answers Rise in satisfaction after EHR - Answer Don't assume it's bc of EHR, do more research Negatives of Using Mean - Answer Influenced by outliers