Healthcare Financial Management Association (HFMA) Bundle Set

Definition of cost - Answer Can be the amount paid for the service. It can also be the amount paid for salaries or to other vendors Direct Cost - Answer Are the costs that can be traced directly to a department, product, or service (Salaries, Employee benefits, medications, supplies, aging an...

Through what document does a hospital establish compliance standards? - Answer Code of Conduct What is the purpose of the OIG work plan? - Answer Communicate issues that will be reviewed during the year for compliance with Medicare regulations If a Medicare patient is admitted on Friday, w...

What has changed for Healthcare Analytics? - Answer 1 - Increased computing power and storage, decrease in cost; 2 - increased abundance of data in healthcare; 3 - increase in individuals having strong competencies Big Data - Answer Refers to the Growth in available data, massive continua...

What has changed for Healthcare Analytics? - Answer 1 - Increased computing power and storage, decrease in cost; 2 - increased abundance of data in healthcare; 3 - increase in individuals having strong competencies Big Data - Answer Refers to the Growth in available data, massive continua...

Learning Objective 1/2: Discuss the components of the 3 HFMA revenue cycle initiatives collectively called Healthcare Dollars & Sense. - Answer n/a Learning Objective 2/2: Summarize the best practices for each of the 3 Healthcare Dollars & Sense Initiatives. - Answer n/a Healthcare Dollars...

Define Revenue Cycle - Answer REVENUE CYCLE ----- is the series of events and services provided prior to, during, and after the course of treatment Departments that contribute to the Revenue Cycle. - Answer Departments that contribute to the Revenue Cycle. 1. Access 2. Health informati...

provider - general - Answer A party rendering medical care such as a physician or hopsital facilities provider - Answer Includes hospitals, skilled nursing facilities, assisted living facilities, home health agencies, and ambulatory centers professional provider - Answer includes physici...

Through what document does a hospital establish compliance standards? - Answer code of conduct What is the purpose OIG work plant? - Answer Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-d...

Purpose of Contracts - Answer Purpose Contracts will be used to define terms between two or more parties for the provision of a service or product. In health care, contracts are used for: Health plan or payer agreements. Construction projects. Collection services. Maintenance on equipment...

Describe the paper and electronic claims flow process. - Answer 1. Electronic Claim Submission= EDI claims forwarded to either directly or via EDI clearing house/ vendor. 2. Claims Verification= Clearinghouse specifications and insurance company requirements used to validate transmitted claims...

Steps used to control costs of managed care include: - Answer Bundled codes Capitation Payer and Provider to agree on reasonable payment 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...