Physician fee amounts - Study guides, Class notes & Summaries

H has suffered a covered disability away from her job and will shortly begin collecting benefits. The insurer sends a letter to H stating that she will not receive any benefit amounts greater than her income. This clause is known as: A: Over-insurance clause B: free look C: relation of earning to insurance D: relation of economic value - answer-C: relation of earning to insurance The insured should be aware of the issue date upon delivery a policy and the date should be listed on: A: the...

BESTQUIZZES COMPREHENSIVE EXIT EXAM – PRIORITY ONE 1. A nurse is assessing a client’s pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications? A. Left ventricular failure B. Cardiogenic shock C. Hypovolemia D. Hypotension 2. A nursing planning care for a school-age child who is 4 hr postoperative following perforated appendicitis. Which of the following actions should the nurse include in the plan ...

Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? correct answersDr. Brennan can charge Mary Rogers no more than the cost sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15% of the Medicare rate. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an at...

Modifiers - provide addtional info about the service/procedure indicating service/procedure has been altered but the definition of the code has not changed. Global Surgery Package - The time, effort, and services required to complete a procedure are bundled together to form a surgery package . Payment is made for a package of services and not each individual service provided within the package. Using RBRVS - CMS annually publishes Physician Fee Schedule information on its website and posts...

AMCA CERTIFICATION TEST - MEDICAL ASSISTING STUDY GUIDE - SET A latest 20221) Which of the following is considered a parasitic infection? A. Lyme disease B. Rabies C. Ringworm D. Malaria ... 2) Aspirin and acetaminophen are examples of: A. Analgesics and antipyretics B. Antitussives and decongestants C. Antihistamines and antiemetics D. Antidotes and antibiotics ... 3) Demerol 75 mg, IM every 4 hours, as needed for severe pain, is what type of medication order? A. Single...

Abuse - Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. Accounts Receivable Management -...

Calculate the following amounts for a participating provider who bills Medicare: Submitted charge (based on provider's regular fee for office visit)$ 75 Medicare physician fee schedule (PFS)$ 60 Coinsurance amount (paid by patient or supplemental insurance)$ 12 Medicare payment (80 percent of the allowed amount)$ ????? Medicare write-off (not to be paid by Medicare or the beneficiary)$ ????? - Medicare payment (80 percent of the allowed amount) $48 Medicare write-off (not to be paid by M...

Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the following ...

The standard office visit fee for a procedure is $1400. Your physician is contracting with ABC insurance and the fee schedule is $1275, what would the contractual adjustment be? a) $125 b) $280 c) $1.020 d) $1.120 a) $125 If both parents have health insurance, the parent whose insurance is primary is the a) Mother b) Father c) One who has had insurance the longest d) One whose birthday is first in the year d) One whose birthday is first in the year In ICD-10-CM, a placeholder chara...

NCCT REVIEW-COLLECTIONS QUESTIONS AND ANSWERS 1. It is important to make the patient aware of the mailing address, interest rates, and length of agreement when setting up a A. fee schedule. B. payment arrangement. C. pre-payment plan. D. deductible fee. - Answer-payment arrangement. —-Rationale—- A payment arrangement is an agreement between the patient and medical office to make monthly payments on a balance that is the patient's responsibility. All the information will be on th...

MHA 710 - Healthcare Economics - Exam 3 Questions and Answers | Latest Version | 2024/2025 | Already Passed 2. If the market were perfectly competitive instead of dominated by a monopsonist, what would the equilibrium wage and level of employment be? a. W1 and E1 b. W2 and E0 c. W0 and E0 d. W0 and E1 e. W0 and E2 a. W1 and E1 A classification system for physicians' services, using a weighting scheme that reflects the relative value of the various services performed. Develope...