Coding compliance plan - Study guides, Class notes & Summaries

Medical Billing and Coding Lesson 1: Reimbursement, HIPAA, and Compliance Already Passed The Medical Coder's Responsibility Each coding system plays a critical role in reimbursement. The role of the medical coder is to optimize payment while adhering to coding guidelines. The coder must accurately code the services, procedures, and diagnosis rendered so that the office is properly reimbursed. Coders may encounter ethical issues about upcoding a procedure or changing a diagnosis to ob...

NHA CBCS CERTIFICATION EXAM QUESTIONS AND ANSWERS 100% PASS Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Correct Answer ️️ -Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Correct Answer ️️ -Encounter form A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is respo...

HCA Certification Training Questions and Answers 100% Solved 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). True According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ 1.Protect our programs 2.Protect your patients 3.Pro...

"hold harmless clause" CORRECT ANSWER-* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: CORRECT ANSWER-* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing house is a CORRECT ANSWER-entity that processes nonsta...

HCA Certification Training Exam 2024 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 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ -Answer-1.Protect our programs 2.Protect your patients 3.Prot...

When coding in operative report what action would NOT be recommended? ANSWER: Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? ANSWER: Medicare administrative contractor (MAC) MAC stands for what!? ANSWER: Medicare administrative contractor What is the definition of coding? ANSWER: Translating documentation into numerical/alphabetical codes used to obt...

NHA Medical Coding and billing exam Questions and Answers 100% Pass Place of Service - Correct Answer ️️ -Billing and coding specialists should first divide the E & M Code by Privacy Officer - Correct Answer ️️ -Compliant with HIPPA the following position should be assigned in each office Principal Diagnosis - Correct Answer ️️ -Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed diagnosis? Urethratresia - Correct Answer ️️ -Obstruction o...

CPMA Exam Questions with Correct Answers When non-compliance is identified, what does the OIG recommended? a .Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action, and the follow-up action taken. b. Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action,and the follow-up action taken. c. Immediately terminate emp...

When coding in operative report what action would NOT be recommended? ANSWER: Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? ANSWER: Medicare administrative contractor (MAC) MAC stands for what!? ANSWER: Medicare administrative contractor What is the definition of coding? ANSWER: Translating documentation into numerical/alphabetical codes used to obt...

HCCA - CHC Study Questions With Complete Solutions . 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). - correct answer. True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - correct answer. 1.Protect our programs 2.Protect your patients 3.Protect the Pro...