Medicare reimbursement Study guides, Class notes & Summaries

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...

Steps used to control costs of managed care include: correct answers Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify correct answers 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 Identify the various types of private health plan coverage correct answers HMO Conventional PPO and POS HDHP/SO plans - high-deductible health...

NURS 6531 QUIZZES Questions and Answers (Latest 2022/2023) Complete Solution, Rated A Question 1 1 out of 1 points Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order? • Question 2 1 out of 1 points Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding pati...

What are qualifications/stipulations for SAR? (for medicare coverage) correct answer: - minimum 3-day qualifying stay in hospital - periodic recertification (minimum data set) - 100 days per year covered max What is a minimum data set? correct answer: comprehensive multidisciplinary assessment done in skilled nursing facility to validate need for care, provide data for reimbursement, maintain assessment, and assess care plan Is community nursing care usually covered by medicare? corr...

Promoting a health care service that improves diabetes management for the elderly in a community would assist in which of the following? a. Supporting the national health goals Healthy People 2020 b. Reducing hunger in a subset of the United States population c. Improving Medicare reimbursement claims d. Providing access to primary health care services ANS: A Healthy People 2020 has a wide influence and is the focus of the nation’s main objective to promote health and prevent disease. ...

The Payroll Source CPP Practice Exam 100 Questions with Verified Answers Which of the following is LEAST likely to be considered when looking at the security of a new payroll system? A. regular data back-up and storage B. protection against computer viruses C. limited system access D. system edits - CORRECT ANSWER D. system edits Company deadlines for payroll data input documents are essential for: A. timely processing of the payroll B. accurate entry of data C. guaranteeing that al...

Test Bank - Gerontologic Nursing, 6th Edition (Meiner, 2019), Chapter 1- 29 | All Chapters Chapter 01: Overview of Gerontologic Nursing Meiner: Gerontologic Nursing, 5th Edition MULTIPLE CHOICE 1. In 2010, the revised Standards and Scope of Gerontological Nursing Practice was published. The nurse would use these standards to: a. promote the practice of gerontologic nursing within the acute care setting. b. define the concepts and dimensions of gerontologic nursing practice. c. eleva...

WGU C425 OA Review (UPDATED)questions and answersWhich of the following is true in regards to health care today in the United States? There are more primary care physicians than specialty physicians. Primary care receives a higher reimbursement in professional fees. There are more specialty physicians than primary physicians. Outpatient care is slowly decreasing. There are more specialty physicians than primary physicians. What triggered the downsizing phase in the U.S. hospital indu...

LA Life, Health & Accident Insurance Series 103 Practice Exam Questions and Answers Already Passed Under which situation must insurable interest exist between the applicant and insured at the time of application? When a third-party applicant names themselves beneficiary. Which of the following is true about a decreasing term life policy? The face amount reaches zero at policy expiration. Which of the following occurs immediately after the application is submitted and the initial premium paid?...

NRNP 6675-15; NRNP 6675 Week 6 Midterm Exam 2022 100% solved -Graded A+   NRNP 6675-15; NRNP 6675 Week 6 Midterm Exam 2022 100% solved -Graded A+ 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply Age Rapid dose escalation Parental route of administration Higher potency typical antipsychotics 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway causing which of the following effects? Reduces negative symptoms Increases e...