Drg is used to - Study guides, Class notes & Summaries

What is tiering? - Ans: The ranking or classifying of one or more of the provider delivery system components Which option is a practice used to control costs of managed care? - Ans: -Making advance payment to providers for all services needed to care for a member -Combining services provided and bundling the associated charges -Agreement between the payer and provider on reasonable payment for each service. Which option is a risk involved in per diem payments? - Ans: -The risk to the ins...

NRNP 6675-15 / NRNP 6675 Week 6 Midterm Exam 2023 100% Verified Graded A+. 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply Age Rapid dose escalation Parental route of administration Higher potency typical antipsychotics 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? Reduces negative symptoms Increases extra pyramidal symptoms (EPS) Causes prolactinemia Reduces pos...

Medicare Hospital Acute Inpatient Payment System Chapter 5 Graded A+ What is the primary purpose of the Medicare Hospital Acute Inpatient Payment System? The primary purpose of the Medicare Hospital Acute Inpatient Payment System is to reimburse hospitals for the costs associated with inpatient care for Medicare beneficiaries. How are payments determined under the Medicare Hospital Acute Inpatient Payment System? Payments are determined using a diagnosis-related group (DRG) system, w...

Access to healthcare Correct Answer-An individual's ability to obtain appropriate health care services is described as either potential (supply) or actual (demand); described degree of fit between client and health system Diagnostic related grouping (DRG) Correct Answer-DRG is a patient classification system used by hospitals to bill and be paid by third party payers. The payment is based on the average cost for the patient's DRG. Patients are assigned to a DRG based upon the patient's dia...

Chapter 01: Nursing and the Health Care System Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition MULTIPLE CHOICE 1. Florence Nightingale’s contributions to nursing practice and education: a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wound...

Medical Billing and Reimbursement Systems Chapter 6 with Complete Solutions How does the fee-for-service reimbursement model work? The fee-for-service model reimburses healthcare providers for each service performed, allowing them to bill separately for every procedure or visit. What is capitation in medical billing? Capitation is a reimbursement model where healthcare providers receive a fixed amount per patient for a specific period, regardless of the number of services provi...

ethics branch of philosophy applied ethics practical applications of moral standard laws binding rules determined by authority medical ethics moral conduct to regulate behavior of medical professionals beneficence principles of doing good veil of ignorance justice-based three-step ethics model Kenneth Blanchard and Norman Vincent Peale's approach to ethics R/O rule out a diagnosis gut feeling decision based on emotion A problem that occurs when using a duty-bas...

The term used to indicate that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care is 1. appropriateness. 2. evidence-based medicine. 3. benchmarking. 4. medical necessity. (Ans- 4. medical necessity. Use the following table to answer the question. (See the word file) This information is the numerical identification of the service or supply. Each item has a unique number with a...

Principles of Healthcare Reimbursement 9 & 10 Questions and Answers 100% Verified How do government programs like Medicare and Medicaid impact healthcare reimbursement? Government programs like Medicare and Medicaid set specific reimbursement rates and guidelines that providers must follow for services rendered to eligible patients. What are the two main types of reimbursement methods in healthcare? The two main types of reimbursement methods in healthcare are fee-for-service and ...

CSPR - Certified Specialist Payment Rep (HFMA) questions with correct answers 1. Steps used to control costs of managed care include :Answer: Bundled codes Capitation Payer and Provider to agree on reasonable payment 2. 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 3. Identify the various types of private health plan coverage:Answer: HMO Conven...