Liability payers - Study guides, Class notes & Summaries

CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR (2024) What are collection agency fees based on? -Answer-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? -Answer-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? -Answer-Case rates What customer service improvements might improve ...

Payer System The United States has a first-party and third-party payment system: first-party = patient third-party = other entity Other Entity: - Government (Medicare/Medicaid) - Group/Individual Insurers - Industrial/Worker's Comp - Automobile Insurers - Liability Insurers - Charitable Organizations Reimbursement Methodologies The processes used by payers to determine how much is actually paid for healthcare services. The most common methodologies are: 1. Fee-For-Service 2. Episode-of-Care...

Comlex Ethics Level 2 Exam 2024 (Verified Answers). What is respondeat superior or vicarious liability? - ANSWER it is when an employer is responsible for the actions of their employees. Both terms essentially mean the same thing. what is res ipsa loquitur? - ANSWER it is when a physician acts negligently to lead to an accident. the thing speaks for itself Example is if a physician prescribes the wrong medication leading to injury or leaves a scalpel inside someone . What is contributor...

1 NR 511 MIDTERM SANNER STUDY EXAM REVIEW QUESTIONS AND ANSWERS, 100% ACCURATE/ Assesses the clients HPI OLDCARTS TRUE or FALSE... The history of present illness is a breakdown of the clients chief complaint TRUE What is needed to make a sound clinical decision Evidence based research clinical practice guidelines published evidence-based algorithms (few false positives) high percentage of healthy people will show a normal result high specificity high number of false positives low...

CDEO Exam Prep REAL EXAM QUESTIONS WITH VERIFIED ANSWERS|WITH RATIONALES What is the central focus of clinical documentation? a. Protection against mal-practice claims b. Communication to office staff and other departments about the patient's care c. To facilitate optimum patient care d. Communication to other the providers and ancillary personnel concerning the patient encounter - ANSWER c. To facilitate optimum patient care The central focus of all clinical documentation should be...

CBCS Exam 2023/2024 with Question and 100% Correct Answers. Medical Billing & Coding as a Career - Correct answer-*Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - Correct answer-Standards of conduct based on moral principle. They a...

CDEO FINAL EXAM 200+ QUESTIONS AND CORRECT ANSWERS 2023/2024. CDEO Exam Prep 2023 1. c. To facilitate optimum patient care The central focus of all clinical documentation should be to demonstrate the quality of care provided to the patient with detail and accuracy to facilitate optimum patient care.: What is the central focus of clinical documentation? a. Protection against mal-practice claims b. Communication to office staff and other departments about the patient's care c. To facil...

Assesses the clients HPI - Answer-OLDCARTS TRUE or FALSE... The history of present illness is a breakdown of the clients chief complaint - Answer-TRUE What is needed to make a sound clinical decision - Answer-Evidence based research clinical practice guidelines published evidence-based algorithms (few false positives) high percentage of healthy people will show a normal result - Answer-high specificity high number of false positives - Answer-low specificity if a diagnostic study has ___...

AAHAM Full Exam A hospital inpatient admit through discharge claim would be what Type of Bill (TOB) on the UB-04? - 111 True/False Average Daily Census is the average number of inpatients maintained in the hospital each day for a specific period of time. - True Which type of claim requires HCPCS/CPT codes? - Outpatient Claims Which of the following is not true of a CAH? -They must maintain no more than 25 inpatient beds that may be used for swing bed services -They may operate a...

Other request than Federal Healthplans - For different reasons other than reimbursement, requests for medical records come from different sources, for a multitude of different reasons. A few of these, other than Federal Health Care Plans, are patients who are becoming more active in their care , attorneys seeking information for third party liability claims or mal-practice claims, other providers involved in the patients' care, employers for pre-employment applications and worker's compens...