Prepayment review - Study guides, Class notes & Summaries

NBDHE Board Review - Dental Community Health Exam Review Questions and answers, graded A+/ Longitudinal - -A study in which df/dmf are conducted yearly on the same group of children is an example of which type of study? Children and young adults in fluoridated and nonfluoridated communities - -Sealant programs are recommended for _________. A fluoride mouth rinse program - -In a nonfluoridated community, which preventative dental health program would have the maximum cost benefit for ...

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...

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...

ICAEW – ACA Fundamental Dr/Cr Accounting Exam Review Questions and Answers 2023/2024 (generic) cash paid during the year in expense ledger - correct answer "dr expense Cr cash " (generic) cash paid received the year in income ledger - correct answer "dr cash Cr income " Calculate whether a closing accrual is required - correct answer "dr expense Cr accruals " Calculate whether a closing accrued income adjustment is required - correct answer "dr accrued income Cr inco...

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...

Adjustment - Answer-Change to a patient's account. Advisory Opinion - Answer-Opinion issued by CMS or OIG that becomes legal advice Allowed Charge - Answer-Maximum charge a plan pays for a service or procedure. Assumption Coding - Answer-reporting undocumented services the coder assumes have been provided due to the nature of the case or condition Audit - Answer-Methodical review Balance Billing - Answer-collecting the difference between a provider's usual fee and a payer's lower allow...

Financial Services Commission The governor and cabinet who select two officials to regulate banking, securities, and insurance Division of Finance Department responsible for licensing, examining and regulating non-depository financial services companies in Florida Bureau of Finance Regulation Conducts examinations of the books and records of mortgage brokers, mortgage brokerage businesses and mortgage lenders to ensure compliance Bureau of Money Transmitter Regulation Co...

NMLS UST Mortgage Exam Questions With Verified Answers A consumer calls to ask about a loan product. How does TILA require you to quote an interest rate to him? - answerThe APR and the interest rate A wraparound mortgage: - answerOccurs when a new mortgage plus an existing mortgage is structured as a single obligation Which of the following is true of an FHA borrower? - answerOnly 75% of rental income counts as qualifying income A mortgage on personal property is a(n): - answerChattel Mo...

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...

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...