Coc chapter 4 - Study guides, Class notes & Summaries

The CMS-1500 claim form is used for reporting: correct answersphysician services in ASC The UB-04 claim form is used for reporting: correct answersfacility services in the outpatient hospital setting When submitting a claim the following questions are answered: correct answersWho? is the provider who performed the service and the patient who received care.What? CPT and HCPCS codes are reported to identify the services performed and supplies used.Where? the location the services are rendere...

82-Rendering Provider: the healthcare professional who delivers or complete a particular medical service or non surgical procedure correct answersWhat provider type qualifier code is used to identify the rendering provider? False; A routine ABN cannot be used when services have no specific identifiable reason correct answersA routine ABN is appropriate for patients who returned to the facility more than once The ABN did not specify the reason Medicare might deny the claim so the patient is...

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...

CHC Random Study Questions 2 with 100% Correct Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. -Answer-Affordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to ad...

CHC Random Study Questions With 100% Verified Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS- OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. - answerAffordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to a...

CHC Random Study Questions 2 with 100% Correct Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. -Answer-Affordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to ad...

CHC Random Study Questions With 100% Verified Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS- OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. - answerAffordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to a...

Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. - ANSWER Affordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to adopt and implement an effective compliance program, which...

CHC Random Study Questions 2 with 100% Correct Answers Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. -Answer-Affordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to ad...

Fill in the blank: The ___________ ____ Act further required that the HHS Secretary, in consultation with HHS-OIG, establish "core elements" for provider and supplier compliance programs within a particular industry or sector. - Correct Answer Affordable Care Pursuant to 42 C.F.R. §§ 422.503(b)(4)(vi), 423.504(b)(4)(vi), and as incorporated into Chapter 21, Section 30 of the "Medicare Managed Care Manual": All sponsors are required to adopt and implement an effective compliance progra...