Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Healthcare Revenue Cycle Management, Exams of Nursing

Various aspects of healthcare revenue cycle management, including patient eligibility verification, claims processing, financial assistance policies, and regulatory compliance. It addresses key topics such as accurate patient information validation, electronic claims submission, denial management, pricing transparency, and the importance of medical records maintenance. Insights into best practices recommended by organizations like hfma, as well as regulatory requirements like hipaa and the affordable care act. It touches on concepts like inpatient admission criteria, medicaid eligibility, and the role of case management in the revenue cycle. Overall, the document offers a comprehensive overview of the complex processes and considerations involved in effectively managing the healthcare revenue cycle.

Typology: Exams

2023/2024

Available from 10/16/2024

Nursing-Is-My-Life
Nursing-Is-My-Life 🇺🇸

773 documents

Partial preview of the text

Download Healthcare Revenue Cycle Management and more Exams Nursing in PDF only on Docsity!

CRCR Certification Correct Questions

And Answers!

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - ANSWERSThe Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - ANSWERSMeet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - ANSWERSRespect the patients privacy A nightly room charge will be incorrect if the patient's - ANSWERSTransfer from ICU (intensive care unit) to the Medical/Surgical floor is not reflected in the registration system The Affordable Care Act legislated the development of Health Insurance Exchanges, where individuals and small businesses can - ANSWERSPurchase qualified health benefit plans regardless of insured's health status A portion of the accounts receivable inventory which has NOT qualified for billing includes: - ANSWERSCharitable pledges What is required for the UB-04/837-I, used by Rural Health Clinics to generate payment from Medicare? - ANSWERSRevenue codes This directive was developed to promote and ensure healthcare quality and value and also to protect consumers and workers in the healthcare system. This directive is called

  • ANSWERSPatient bill of rights The activity which results in the accurate recording of patient bed and level of care assessment, patient transfer and patient discharge status on a real-time basis is known as - ANSWERSCase management Which statement is an EMTALA (Emergency Medical Treatment and Active Labor Act) violation? - ANSWERSRegistration staff may routinely contact managed are plans for prior authorizations before the patient is seen by the on-duty physician HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify the employer of an individual described in a transaction EIN's are assigned by - ANSWERSThe Internal Revenue Service

Checks received through mail, cash received through mail, and lock box are all examples of - ANSWERSControl points for cash posting What are some core elements if a board-approved financial assistance policy? - ANSWERSEligibility, application process, and nonpayment collection activities A recurring/series registration is characterized by - ANSWERSThe creation of one registration record for multiple days of service With the advent of the Affordable Care Act Health Insurance Marketplaces and the expansion of Medicaid in some states, it is more important than ever for hospitals to - ANSWERSAssist patients in understanding their insurance coverage and their financial obligation The purpose of a financial report is to: - ANSWERSPresent financial information to decision makers Patient financial communications best practices produce communications that are - ANSWERSConsistent, clear and transparent Medicare has established guidelines called the Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) that establish - ANSWERSWhat services or healthcare items are covered under Medicare Any provider that has filed a timely cost report may appeal an adverse final decision received from the Medicare Administrative Contractor (MAC). This appeal may be filed with - ANSWERSThe Provider Reimbursement Review Board Concurrent review and discharge planning - ANSWERSOccurs during service Duplicate payments occur: - ANSWERSWhen providers re-bill claims based on nonpayment from the initial bill submission An individual enrolled in Medicare who is dissatisfied with the government's claim determination is entitled to reconsideration of the decision. This type of appeal is known as - ANSWERSA beneficiary appeal Insurance verification results in which of the following - ANSWERSThe accurate identification of the patient's eligibility and benefits The Medicare fee-for service appeal process for both beneficiaries and providers includes all of the following levels EXCEPT: - ANSWERSJudicial review by a federal district court

Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the providermay not ask about a patient's insurance information if it would delay what? - ANSWERSMedical screening and stabilizing treatment Ambulance services are billed directly to the health plan for - ANSWERSServices provided before a patient is admitted and for ambulance rides arranged to pick up the patient from the hospital after discharge to take him/her home or to another facility Key performance indicators (KPIs) set standards for accounts receivables (A/R) and - ANSWERSProvide a method of measuring the collection and control of A/R he patient discharge process begins when - ANSWERSThe physician writes the discharge orders The nightly room charge will be incorrect if the patient's - ANSWERSTransfer from ICU to the Medical/Surgical floor is not reflected in the registration system. The soft cost of a dissatisfied customer is - ANSWERSThe customer passing on info about their negative experience to potential pts or through social media channels An advantage of a pre-registration program is - ANSWERSThe opportunity to reduce the corporate compliance failures within the registration process It is important to have high registration quality standards because - ANSWERSInaccurate or incomplete patient data will delay payment or cause denials Telemed seeks to improve a patient's health by - ANSWERSPermitting 2-way real time interactive communication between the patient and the clinical professional Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment services for an enrolled group of persons based on a monthly fee is known as a - ANSWERSHMO Identifying the patient, in the MPI, creating the registration record, completing medical necessity screening, determining insurance eligibility and benefits resolving managed care, requirements and completing financial education/resolution are all - ANSWERSThe data collection steps for scheduling and pre-registering a patient Medicare Part B has an annual deductible, and the beneficiary is responsible for - ANSWERSA co-insurance payment for all Part B covered services The standard claim form used for billing by hospitals, nursing facilities, and other inpatient - ANSWERSUB- Charges are the basis for - ANSWERSSeparation of fiscal responsibilities between the patient and the health plan

All of the following are forms of hospital payment contracting EXCEPT - ANSWERSContracted Rebating The most common resolution methods for credit balances include all of the following EXCEPT: - ANSWERSDesignate the overpayment for charity care Ambulance services are billed directly to the health plan for - ANSWERSThe portion of the bill outside of the patient's self-pay A claim for reimbursement submitted to a third-party payer that has all the information and documentation required for the payer to make a decision on it is known as - ANSWERSA clean claim The healthcare industry is vulnerable to compliance issues, in large part due to the complexity of the statutes and regulations pertaining to - ANSWERSMedicare and Medicaid payments The Correct Coding Initiative Program consists of - ANSWERSEdits that are implemented within providers' claim processing systems To provide a patient with information that is meaningful to them, all of the following factors must be included EXCEPT - ANSWERSThe actual physician reimbursement Which department supports/collaborates with the revenue cycle? - ANSWERSInformation Technology Medicare Part B has an annual deductible and the beneficiary is responsible for - ANSWERSa co-insurance payment for all Part B covered services The two types of claims denial appeals are - ANSWERSBeneficiary and Provider Which of the following is a violation of the EMTALA (Emergency Medical Treatment and Labor Act?) - ANSWERSRegistration staff members routinely contact managed care plans for prior authorizations before the patient is seen by the on duty physician Rural Health Clinics (RHC) personnel can provide services in all of the following locations, EXCEPT - ANSWERSProviding inpatient services in the RHC The patient discharge process begins when - ANSWERSThe physician writes the discharge order Departments that need to be included in charge master maintenance include all of the following EXCEPT - ANSWERSQuality Assurance

The first thing a health plan does when processing a claim is - ANSWERSCheck if the patient is a health plan beneficiary and what is the coverage Vital to accurate calculations of a patient's self-pay amount is - ANSWERS The most accurate way to validate patient information is to - ANSWERSrequire clinical staff to verify information at each treatment encounter In order for Regulation Z to apply, a hospital must - ANSWERS All of the following are minimum requirements for new patients with no MPI number EXCEPT - ANSWERSAddress A typical routine patient financial discussion would include - ANSWERSExplaining the benefits identified through verifying the patients insurance Components of financial education include informing the patient of the hospital's financial policies, assessing the patient's ability to pay and - ANSWERSReviewing payment alternatives with the patient so appropriate resolution of the health care financial obligation is achieved HFMA best practices indicate that the technology evaluation is conducted to - ANSWERSContinually align technology with processes rather than technology dictating processes Scheduler instructions are used to prompt the scheduler to - ANSWERSComplete the scheduling process correctly based on service requested When billing Rural Health Clinic services on a UB-04/837-I, specific CPT codes are collapsed into a single revenue code (520 or 521). Although codes are collapsed into a single revenue code, it is still important to list the appropriate CPT codes as part - ANSWERSThese codes will be used to determine medical necessity and useful in determining what happened during the encounter What is likely to occur if credit balances are not identified separately from debit balances in accounts receivable? - ANSWERSThe accounts receivable level would be understated The process of verifying health insurance coverage, identifying contract terms, and obtaining total charges is known as - ANSWERSinsurance verification and reimbursable charges Unless the patient encounter is an emergency, it is more efficient and effective to - ANSWERSCollect all information after the patient has been discharged

Applying the contracted payment amount to the amount of total charges yields - ANSWERSA pricing agreement "Hard-coded" is the term used to refer to - ANSWERSCodes for services, procedures, and drugs automatically assigned by the charge master The advantages to using a third-party collection agency include all of the following EXCEPT - ANSWERSProviders pay pennies on each dollar collected Which of the following is usually covered on a Conditions of Admission form - ANSWERSRelease of information The 501(r) regulations require not-for-profit providers (501(c)(3) organizations) to do which of the following activities. - ANSWERSComplete a community needs assessment and develop a discount program for patient balances after insurance payment To be eligible for Medicaid, an individual must - ANSWERSmeet income and asset requirements Eliminating mail time and reducing data entry time, electronically monitoring the receipt of claims and online claim adjudication, more prompt payment are all benefits achieved by - ANSWERSThe electronic submission of claims using electronic transfers There are unique billing requirements based on - ANSWERSThe provider type The unscheduled "direct" admission represents a patient who: - ANSWERSIs admitted from a physician's office on an urgent basis In resolving medical accounts, a law firm may be used as: - ANSWERSA substitute for a collection agency The legal authority to request and analyze provider claim documentation to ensure that - ANSWERSThe Office of the U.S. Inspector General (OIG) The office of inspector general (OIG) publishes a compliance work plan - ANSWERSAnnually Room and bed charges are typically posted - ANSWERSFrom the midnight census All of the following information should be reviewed as part of schedule finalization EXCEPT: - ANSWERSThe results of any and all test Revenue cycle activities occurring at the point-of-service include all of the following EXCEPT: - ANSWERSProviding charges to the third-party payer as they are incurred

HFMA's patient financial communications best practices specify that pts should be told about the - ANSWERSThe service providers that typically participate in the service, e.g. radiologists ,pathologists, etc. The core financial activities resolved within patient access include: - ANSWERSScheduling, pre-registration, insurance verification and managed care processing A decision on whether a patient should be admitted as an inpatient or become about patient observation patient requires medical judgments based on all of the following EXCEPT - ANSWERSThe patient's home care coverage Which option is a benefit of pre-registering a patient for services - ANSWERSThe patient arrival process is expedited, reducing wait times and delays Days in A/R is calculated based on the value of - ANSWERSThe total accounts receivable on a specific date Case Management requires that a case manager be assigned - ANSWERSTo a select patient group Which of the following is required for participation in Medicaid? - ANSWERSMeet income and assets requirements All of the following are steps in safeguarding collections EXCEPT - ANSWERSIssuing receipts The Electronic Remittance Advice (ERA) data set is : - ANSWERSA standardized form that provides third party payment details to providers All of the following are conditions that disqualify a procedure or service from being paid for by Medicare EXCEPT - ANSWERSServices and procedures that are custodial in nature Medicare beneficiaries remain in the same "benefit period" - ANSWERSUntil the beneficiary is "hospitalization and/or skilled nursing facility-free" for 60 consecutive days It is important to calculate reserves to ensure - ANSWERSStable financial operations and accurate financial reporting A claim is denied for the following reasons, EXCEPT: - ANSWERSThe submitted claim does not have the physicians signature HFMA best practices call for patient financial discussions to be reinforced - ANSWERSBy changing policies to programs

Patients should be informed that costs presented in a price estimate may - ANSWERSVary from estimates, depending on the actual services performed The nuanced data resulting from detailed ICD-10 coding allows senior leadership to work with physicians to do all of the following EXCEPT: - ANSWERSObtain higher compensation for physicians Charges as the most appropriate measurement of utilization enables - ANSWERSAccuracy of expense and cost capture Once the EMTALA requirements are satisfied - ANSWERSThe remaining registration processing is initiated at the bedside or in a registration area Across all care settings, if a patient consents to a financial discussion during a medical encounter to expedite discharge, the HFMA best practice is to: - ANSWERSSupport that choice, providing that the discussion does not interfere with patient care or disrupt patient flow In Chapter 7 straight bankruptcy filling - ANSWERSThe court liquidates the debtor's nonexempt property, pays creditors, and discharges the debtor from the debt Chapter 13 Bankruptcy, debtor rehabilitation is a court proceeding - ANSWERSThat reorganizes a debtor's holdings and instructs creditors to look to the debtors' future earnings for payment This concept encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits - ANSWERSClaims processing The importance of Medical records being maintained by HIM is that the patient records:

  • ANSWERSAre the primary source for clinical data required for reimbursement When there is a request for service, the scheduling staff member must confirm the patient's unique identification information to - ANSWERSEnsure that she/he accesses the correct information in the historical database Maintaining routine contact with the health plan or liability payer, making sure all required information is provided and all needed approvals are obtained is the responsibility of: - ANSWERSCase Management Key Performance Indicators (KPIs) set standards for accounts receivables (A/R) and - ANSWERSProvide a method of measuring the collection and control of A/R With any remaining open balances, after insurance payments have been posted, the account financial liability is - ANSWERSPotentially transferred to the patient

Pricing transparency is defined as readily available information on the price of healthcare services, that together with other information, help define the value of those services and enable consumers to - ANSWERSIdentify, compare, and choose providers that offer the desired level of value All of the following are potential causes of credit balances EXCEPT - ANSWERSA patient's choice to build up a credit against future medical bills A comprehensive "Compliance Program" is defined as - ANSWERSSystematic procedures to ensure that the provisions of regulations imposed by a government agency are being met An originating site is - ANSWERSThe location of the patient at the time the service is provided Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are Medicare established guideline(s) used to determine: - ANSWERSWhich diagnoses, signs, or symptoms are reimbursable If further treatment can only be provided in a hospital setting, the patient's condition cannot be evaluated and/or treated within 24 hours, or if there is not an anticipation of improvement in the patient's condition with 24 hours, the patient - ANSWERSWill be admitted as an inpatient The benefit of Medicare Advantage Plan is - ANSWERSPatients generally have their Medicare-coverage healthcare through the plan and do not need to worry about "part a" or "part b" benefits The process of creating the pre-registration record ensures - ANSWERSAccurate billing Claims with dates of service received later than one calendar year beyond the date of service, will be - ANSWERSDenied by Medicare A portion of the accounts receivable inventory which has NOT qualified for billing includes - ANSWERSCharitable pledges The standard claim form used for billing by hospitals, nursing facilities, and other in- patient - ANSWERSUB- Once the price is estimated in the pre-service stage, a provider's financial best practice is to - ANSWERSExplain to the patient their financial responsibility and to determine the plan for payment Internal controls addressing coding and reimbursement changes are put in place to guard against - ANSWERSCompliance fraud by upcoding

Health Plan Contracting Departments do all of the following EXCEPT - ANSWERSEstablish a global reimbursement rate to use with all third-party payer For routine scenarios, such as patients with insurance coverage or a known ability to pay, financial discussions: - ANSWERSShould take place between the patient or guarantor and properly trained provider representatives What type of account adjustment results from the patient's unwillingness to pay a self- pay balance? - ANSWERSBad debt adjustment Most major health plans including Medicare and Medicaid, offer - ANSWERSElectronic and/or web portal verification The important Message from Medicare provides beneficiaries information concerning their - ANSWERSRight to appeal a discharge decision if the patient disagrees with the plan Under EMTALA (Emergency Medical Treatment and Labor Act) regulations, the provider may not ask about a patient's insurance information if it would delay what? - ANSWERSMedical screening and stabilizing treatment Before classifying and subsequently writing off an account to financial assistance or bad debt, the hospital must establish policy, define appropriate criteria, implement - ANSWERSMonitor compliance Medicare will only pay for tests and services that - ANSWERSMedicare determines are "reasonable and necessary" The physician who wrote the order for an inpatient service and is in charge of the patients - ANSWERSThe attending physician When primary payment is received, the actual reimbursement - ANSWERSIs compared to the expected reimbursement, the remaining contractual adjustments are posted, and secondary claims are submitted The ICD-10 codes set and CPT/HCPCS code sets combines provide - ANSWERSThe specificity and coding needed to support reimbursement claims In a self-insured (or self-funded) plan, the costs of medical care are - ANSWERSBorne by the employer on a pay-as-you-go basis Indemnity plans usually reimburse: - ANSWERSA certain percentage of the charges after the patient meets the policy's annual deductible The first and most critical step in registering a patient, whether scheduled or unscheduled, is - ANSWERSVerifying the patient's identification

When Recovery Audit Contractors (RAC) identify improper payments as over payments, the - ANSWERSSend a demand letter to the provider to recover the over payment amount Across all care settings, if a patient consents to a financial discussion during a medical encounter - ANSWERSSupport that choice, providing that the discussion does not interfere with patient care or disrupt patient flow Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by: - ANSWERSEach state's Medicaid plan Medicare patients are NOT required to produce a physician order to receive which of these services - ANSWERSScreening Mammography, flu vaccine or pneumonia vaccine EFT (electronic funds transfer) is - ANSWERSAn electronic transfer of funds from payer to payee The importance of medical records being maintained by HIM is that the patient records - ANSWERSAre the primary source for clinical data required for reimbursement by health plans and liability payers Days in A/R is calculated based on the value of: - ANSWERSThe time it takes to collect anticipated revenue To maximize the value derived from customer complaints, all consumer complaints should be - ANSWERSResponded to within two business days A scheduled inpatient represents an opportunity for the provider to do which of the following? - ANSWERSComplete registration and insurance approval before service In the pre-service stage, the requested service is screened for medical necessity, health

  • ANSWERSPre-authorization are obtained Hospitals need which of the following information sets to assess a patient's financial status: - ANSWERSPatient and guarantor's income, expenses and assets Patients are contacting hospitals to proactively inquire about costs and fees prior to - ANSWERSThe fact that charge master lists the total charge, not net charges that reflect charges after a payer's contractual adjustment HIPAA had adopted Employer Identification Numbers (EIN) to be used in standard transactions to identify the employer of an individual described in a transaction EIN's are assigned by - ANSWERSThe Internal Revenue Service

The HCAHPS (hospital consumer assessment of healthcare providers and systems) initiative - ANSWERSProvide a standardized method for evaluating patient's perspective on hospital care. A large number of credit balances are not the result of overpayments but of - ANSWERSPosting errors in the patient accounting system A Medicare Part A benefit period begins: - ANSWERSWith admission as an inpatient Chapter 13 Bankruptcy, debtor rehabilitation, is a court proceeding - ANSWERSThat reorganizes a debtor's holdings and instructs creditors to look to the debtor's future earnings for payment Which of the following in NOT included in the Standardized Quality Measures - ANSWERSCost of services The disadvantages of outsourcing include all of the following EXCEPT: - ANSWERSReduced internal staffing costs and a reliance on outsourced staff Improving the overall patient experience requires revenue cycle leadership and staff to simultaneously be: - ANSWERSClear on policies and consistent in applying the policies Because 501(r) regulations focus on identifying potential eligible financial assistants patients hospitals must: - ANSWERSHold financial conversations with patients as soon as possible Which of the following is NOT contained in a collection agency agreement? - ANSWERSA mutual hold-harmless clause HFMA best practices stipulate that a reasonable attempt should be made to have the financial - ANSWERSAs early as possible, before a financial obligation is incurred Recognizing that health coverage is complicated and not all pts are able to navigate this terrain, HFMA best practices specify that - ANSWERSPatients should be given the opportunity to request a patient advocate, family member or other designee to help them In these discussions For scheduled patients, important revenue cycle activities In the Time of Service stage DO NOT INCLUDE: - ANSWERSFinal bill is presented for payment HFMA's patient financial communication best practices specify that patients should be told about the types of services provided and - ANSWERSThe service providers that typically participate in the service, e.g., radiologists, pathologists, etc. Successful account resolution begins with - ANSWERSCollecting all deductibles and copayments during the pre-service stage

Recognizing that health coverage is complicated and not all patients are able to navigate this terrain, HFMA best practices specify that - ANSWERSPatients should be given the opportunity to request a patient advocate, family member, or other designee to help them in these discussions In the balance resolution process, providers should: - ANSWERSAsk the patient if he or she would like to receive information about payment options and supportive financial assistance programs Business ethics, or organizational ethics represent: - ANSWERSThe principles and standards by which organizations operate Which option is a government-sponsored health care program that is financed through taxes and general revenue funds - ANSWERSMedicare Any healthcare insurance plan that provides or ensures comprehensive health maintenance and treatment services for an enrolled group of persons based on; a monthly fee is known as a - ANSWERSHMO In a Chapter 7 Straight Bankruptcy filing - ANSWERSThe court liquidates the debtor's nonexempt property, pays creditors, and discharges the debtor from the debt When there is a request for service the scheduling staff member must confirm the patient's - ANSWERSEnsure that she/he accesses the correct information in the historical database A four digit number code established by the National Uniform Billing Committee (NUBC)that categorizes/classifies a line item in the charge master is known as - ANSWERSRevenue codes Appropriate training for patient financial counseling staff must cover all of the following EXCEPT: - ANSWERSDocumenting the conversation in the medical records The ACO investment model will test the use of pre-paid shared savings to - ANSWERSEncourage new ACOs to form in rural and underserved areas When recovery audit contractors (RAC) identify improper payments as over payments the claims processing contractor must - ANSWERSSend a demand letter to the provider to recover the over payment amount The purpose of the ACA mandated Community Health Needs Assessment is - ANSWERSTo identify significant health needs, prioritize those needs and identify resources to address them

A balance sheet is - ANSWERSA statement of assets, liabilities, and capital for an organization at a specified point in time Hospitals can only convert an inpatient case to observation if the hospital utilization review committee determines this status before the patient is discharged and - ANSWERSPrior to billing, that an observation setting will be more appropriate During pre-registration, a search for the patients MPI number is initiated using which of the following data sets? - ANSWERSPatient's full legal name and date of birth or the patient's Social Security number Because case managers document the clinical reasons for treatment, they are - ANSWERSA good resource when developing written appeals of denials The Truth in Lending Act establishes - ANSWERSDisclosure rules for consumer credit sales and consumer loans What is Continuum of Care? - ANSWERSThe coordination and linkage of resources needed to avoid the duplication of services and the facilitation of a seamless movement among care settings HIPAA privacy rules require covered entities to take all of the following actions EXCEPT

  • ANSWERSUse only designated software platforms to secure patient data The Two Midnight Rule allows hospitals to account for total hospital time when determining if an inpatient admission order should be written based on - ANSWERSA beneficiary needing a minimum of 48 hours of care Since passage of the Affordable Care Act Health Insurance Marketplaces and the expansion of Medicaid in some states, it is more important than ever for hospitals to - ANSWERSAssist patients in understanding their insurance coverage and their financial obligation HFMA patient financial communications best practices call for annual training for all staff EXCEPT - ANSWERSNursing The process of verifying health insurance coverage, identifying contract terms, and obtaining total charges is known as - ANSWERSInsurance verification of reimbursable charges Net Accounts Receivable is - ANSWERSThe amount an entity is reasonably confident of collecting from overall accounts receivable. ED patients should be informed that their ability to pay - ANSWERSWill not interfere with treatment of any emergency medical conditions

Providers are advised that it is best to establish patient financial responsibility and assistance policies and make sure they are followed internally and by - ANSWERSBusiness affiliates Incorrect data gathering can cause all of the following EXCEPT - ANSWERSThe inability to discuss quality with physicians All Hospitals are required to establish a written financial assistance policy that applies to

  • ANSWERSAll emergency and medically necessary care All of the following are reference resources used to help guide in the application of business ethics EXCEPT - ANSWERSConsumer satisfaction reports Each patient is assigned a unique number, commonly called the - ANSWERSMaster Patient Index (MPI) number HIPAA contains all of the following goals EXCEPT - ANSWERSTo ensure proper coding across the continuum of care Which of the following is NOT included in the Standardized Quality Measures? - ANSWERS Account Receivable (A/R) Aging reports - ANSWERSDivide accounts receivable into 30, 60, 90 ,120 days past due categories Patients expect value for their healthcare dollar, including greater transparency of - ANSWERSQuality and price information The impact of denials on the revenue cycle includes all of the following EXCEPT - ANSWERSPatient outcomes Examples of ethics violations that impact the revenue cycle include all of the following EXCEPT - ANSWERSSeeking payment options for patient self-pay Scheduled procedures routinely include - ANSWERSPatient preparation instructions ICD-10-CM and ICD-10-PCS codes sets are modifications of - ANSWERSThe International ICD-10 codes as developed by the WHO (World Health Organization) The result of accurate census balancing on a daily basis is - ANSWERSThe correct recording of room charges All of the following are steps in verifying insurance EXCEPT - ANSWERSThe patient signing the statement of financial responsibility

Health Information Management (HIM) is responsible for - ANSWERSAll patient medical records This form contains major items, subdivided into a total of 55 detailed items, and is used by professional service providers and not hospitals for submitting claims for services to health plans this form is called - ANSWERSThe 1500 Which of the following is NOT a factor in self-pay follow-up? - ANSWERSThe type of patient (inpatient, out-patient) The Office of Inspector General (OIG) was created - ANSWERSDetect and prevent fraud, waste, and abuse

  • ANSWERS