The risks of outsourcing include all the following EXCEPT:
a) The effect of customer service or patient family members
b) The impact of loss of direct manipulate of debts receivable services
c) Increased charges due to seller ineffectiveness
d) Reduced internal staffing fees and a reliance on outsourced body of workers - ANSD
The Medicare price-for carrier attraction method for both beneficiaries and providers
consists of all of the following levels EXCEPT:
a) Medical necessity review through an impartial doctor's panel
b) Judicial overview via a federal district courtroom
c) Redetermination with the aid of the organization that handles claims for
Medicare
d) Review by way of the Medicare Appeals Council (Appeals Council) - ANSB
Business ethics, or organizational ethics represent:
a) The principles and standards by way of which corporations perform
b) Regulations that have to be followed through regulation
c) Definitions of suitable customer support
d) The code of acceptable behavior - ANSA
A part of the accounts receivable stock which has NOT qualified for billing
consists of:
a) Charitable pledges
b) Accounts created at some stage in pre-registration however no longer activated
c) Accounts coded but held inside the suspense period
d) Accounts assigned to a pre-series employer - ANSA
Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) are
Medicare established tenet(s) used to determine:
a) Medicare and Medicaid company eligibility
b) Medicare outpatient repayment quotes
c) Which diagnoses, signs, or signs and symptoms are reimbursable
d) What Medicare reimburses and what must be cited
Medicaid - ANSC
Days in A/R is calculated based totally on the fee of:
a) The overall money owed receivable on a selected date
,b) Total predicted sales minus prices
c) The time it takes to gather predicted revenue
d) Total cash acquired to this point - ANSC
Patients are contacting hospitals to proactively inquire about prices and costs previous to
agreeing to provider. The hassle for hospitals in imparting such records is:
a) That hospitals do not want to set up a charge with out understanding if
the affected person has insurance and how much reimbursement may be
anticipated
b) The reality that fee master lists the full price, not net fees
that mirror fees after a payer's contractual adjustment
c) That hospitals don't need to be put within the position of
"ensuring" rate while not having room for added expenses
that can get up within the course of treatment
d) Their reluctance to proportion proprietary information - ANSB
Across all care settings, if a affected person consents to a monetary discussion at some
point of a clinical
come upon to expedite discharge, the HFMA first-rate practice is to:
a) Make positive that the attending staff can answer questions and
help in acquiring required patient monetary information
b) Have a affected person financial duties package ready for the affected person,
containing all of the required registration bureaucracy and instructions
c) Support that desire, presenting that the dialogue does not
interfere with affected person care or disrupt affected person flow
d) Decline such request as finance discussions can disrupt affected person
care and affected person go with the flow - ANSC
A comprehensive "Compliance Program" is defined as
a) Annual prison audit and overview for adherence to guidelines
b) Educating staff on guidelines
c) Systematic approaches to ensure that the provisions of
policies imposed through a central authority enterprise are being met
d) The improvement of operational policies that correspond to
policies - ANSC
Case Management requires that a case supervisor be assigned
a) To sufferers of any doctor inquiring for case management
b) To a choose patient organization
c) To every patient
d) To specific cases exact with the aid of third birthday celebration contractual agreement -
ANSB
Pricing transparency is described as simply available data on the price of
, healthcare offerings, that together with different information, help outline the value of those
offerings and permit consumers to
a) Identify, examine, and choose vendors that provide the desired
degree of cost
b) Customize fitness care with a in my view chosen mix of providers
c) Negotiate the price of health plan premiums
d) Verify the cost of character clinicians - ANSA
Any healthcare coverage plan that gives or ensures complete health
renovation and treatment services for an enrolled group of individuals primarily based on a
month-to-month fee is called a
a) MSO
b) HMO
c) PPO
d) GPO - ANSB
In a Chapter 7 Straight Bankruptcy filing
a) The courtroom liquidates the debtor's nonexempt property, can pay
lenders, and discharges the debtor from the debt
b) The court docket liquidates the debtor's nonexempt belongings, pays
lenders, and starts offevolved to repay the largest claims first. All claims
are paid a few part of the quantity owed
c) The courtroom vacates all claims in opposition to a debtor with the
know-how that the debtor won't observe for credit with out
court supervision
d) The courtroom establishes a creditor charge time table with the
longest remarkable claims paid first - ANSA
The center financial sports resolved inside affected person get admission to include:
a) Scheduling, pre-registration, coverage verification and controlled
care processing
b) Scheduling, coverage verification, medical discharge processing
and payment posting of factor of service receipts
c) Scheduling, registration, rate access and controlled care
processing
d) Scheduling, pre-registration, registration, medical necessity
screening and affected person refunds - ANSA
Which of the subsequent is NOT contained in a group company agreement?
A) A clean know-how that the provider retains possession of any
outsourced activities
b) Specific language as to who can pay prison costs, if needed
c) An annual renewal clause
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