According to cms - Study guides, Class notes & Summaries

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided ...

Primary Care : A Collaborative Practice, 6th Edition Terry Buttaro, JoAnn Trybulski, Patricia Polgar-Bailey Joanne Sandberg-Cook Chapter 1: The Evolving Landscape of Collaborative Practice Test Bank Multiple Choice 1. Which assessments of care providers are performed as part of the Value Based Purchasing initiative? Select all that apply. a. Appraising costs per case of care for Medicare patients b. Assessing patients’ satisfaction with hospital care c. Evaluating available evidence to guide c...

Primary Care : A Collaborative Practice, 5th Edition Terry Buttaro, JoAnn Trybulski, Patricia Polgar-Bailey Joanne Sandberg-Cook Chapter 1: The Evolving Landscape of Collaborative Practice Test Bank Multiple Choice 1. Which assessments of care providers are performed as part of the Value Based Purchasing initiative? Select all that apply. a. Appraising costs per case of care for Medicare patients b. Assessing patients’ satisfaction with hospital care c. Evaluating available evidence to guide c...

NHA,CBCS (2024/ 2025) Exam | Questions and Verified Answers| 100% Correct| Grade A Q: Which of the following actions by a billing and coding specialist would be considered fraud? Answer: Billing for services not provided Q: The >< symbol is used to indicate a new and revised test other than which of the following? Answer: Procedure descriptors Q: On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following? Answer: The...

PTCB EXAM TEST BANK QUESTIONS AND ANSWERS LATEST WITH RATIONALE Multiple choice What is the route of administration for a prescription with the following directions: "i supp pr q 6 hr prn"? A. Orally B. Rectally C. Urethrally D. Vaginall {{Correct Ans- B. Rectally Rationale: "pr" means per rectum. What is the meaning of PDA? A. Personal digital aid B. Personal digital assistant C. Physician digital assistant D. Pharmaceutical data assistant {{Correct Ans- B. Personal dig...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the app...

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form A patient comes to the hospital for ...

CPCO EXAM 2024 WITH 100% CORRECT ANSWERS Does Medicare pay for all tests ordered by Providers? - correct answer No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - correct answer Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - correct answer To receive a denial so a claim can be submit...

CPCS Exam Questions & Answers 2024/2025 What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - ANSWERSHFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - ANSWERSMedical School, AMA, ECFMG, AOA According to NCQA practitioners must be notified of credentialing decision within how many days? - ANSWERS60 Days The DHHS mails a copy of the NPDB report to the named ...

What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? -Answer HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education -Answer Medical School, AMA, ECFMG, AOA According to NCQA practitioners must be notified of credentialing decision within how many days? -Answer 60 Days The DHHS mails a copy of the NPDB report to the named provider. If the provider wishes to dispute the re...