Drg is used to Study guides, Class notes & Summaries

C425 WGU Objective assessment study guide questions and correct answers 2022VISN-veterans integrated service networks coordinates its own services and receives federal funds/ The hallmark of US healthcare industry Access is restricted to those who -Have health insurance through employer -are covered under a government program -can afford to buy insurance out of pocket -are abel to pay for services privately Holistic medicine treast the whole person/ incorporates alternative t...

Linear regression - ANSWER-In conversations with her patients, a physical therapist notices that patients who are on Workman's Compensation and have supportive supervisors, eager for them to return to work, have more positive outcomes in rehabilitation than those patients whose supervisors have a negative attitude toward their employee's injury: insisting they not return to work until they are at 100% because if anything less they are "useless to the job". What type of test could the ther...

Medicare Health insurance for those over age 65, people under 65 with certain disabilities & those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney transplant) CMS Centers for Medicare and Medicaid Services administers the Medicare program. Social Security Administration handles most of the enrollment & plays a role in claims appeal process. MAC Medicare Administrative Contractor - company contracted to administer Part A & Part B claims....

ACHE BOG Practice Exam 2024 REVIEW # 1 According to the ACHE’s Code of Ethics, one way that healthcare executives can avoid or minimize the negative implications of conflict of interest is to: Make the conflict known to those in superior positions. #2 The principles of quality improvement require that healthcare executives change their management philosophy from: Finding fault with employees to finding problems in processes. #3 What type of problem arises when...

Changing an existing field, record, or file in a database is called indexing modification inserting appending correct answer: modification IV medication is administered in which one of the following manners? Drops per minute Drops per hour Drops per 24-hour period Drops per second correct answer: Drops per minute Which of the following is not a major objective that guided the development of ICD-10-PCS? These are all objectives used in the development of ICD-...

CSPR - Certified Specialist Payment Rep (HFMA) questions with correct answers 1. Steps used to control costs of managed care include :Answer: Bundled codes Capitation Payer and Provider to agree on reasonable payment 2. DRG is used to classify:Answer: Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred 3. Identify the various types of private health plan coverage:Answer: HMO Conven...

HIT Domain 1 Exam Questions With 100% Verified Answers Latest 2024/2025 (100% Correct) In long-term care, the resident's care plan is based on data collected in the? UHDDS OASIS MDS HEDIS MDS (Minimum Data Set) Which of the following statements describes alphabetical filing? File the record alphabetically by first name, followed by last name alphabetically and then alphabetically by middle name File the record alphabetically by the last name, followed by alphabetical order of the first...

HFMA CRCR exam 2024 with 100% correct answers HFMA CRCR exam 2024 with 100% correct answers Through what document does a hospital establish compliance standards? Code of Conduct What is the purpose of the OIG work plan? Communicate Issues that will be reviewed during the year for compliance with Medicare Regulations If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? Diagnostic services and related charges provided on Wednesday, Thur...

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) $ ????? correct answer: Medicare payment (80 percent of the allowed amount) $48 Medicare write-...

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 Mana...