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Which of the following forms gives permission for the payer to send payment to the provider? - Correct ️️ Assignment of Benefits Which is a TRUE statement for radiology orders in a medical record? - Correct ️️ It is not necessary for the orders to be maintained in the patient's file, but...

The following should be included in what type of encounter; DOS,total time by individual modality, signature, and any addtional info relating to progress. - Correct ️️ Therapy Treatment Encounter For each day of PT tx encounter provided to a Medicare patient, what should be documented for th...

What elements must be in a medical record - Correct ️️ Patient ID, Assignment of Benefits, medical history, immunizations, physical exam, lab report, clinical impression, physician orders What is the minimum signature assignment of the author of entry in the medical record? - Correct ️️ F...

Most common commercial insurance plans are - Answer ️️ contract based That is, benefits arise primarily under a contract between the insurance company and the subscriber/patient Where the healthcare provider is in network, - Answer ️️ the provider agrees to abide by certain rules in a se...

The Joint Commission requires that Factors that Affect Learning must be ascertained for a hospital or hospital owned physician practice when assessing this element what does this include? - Correct ️️ *The patients ability to read, method learning, & understanding. *Any language or physical d...

SOAP - Correct ️️ Subjective, Objective, Assessment, Plan CHEDDAR - Correct ️️ Chief complaint, Hx, Exam, Details of problem/complaint, Drugs & dosages, Assessment, Return visit Subjective - Correct ️️ Pt complaint Objective - Correct ️️ Provider observation Assessment - Correct...

Evaluation and Management documentation is often captured in SOAP format, which is the acronym for: - Correct ️️ Subjective, Objective, Assessment, Plan Failure to have which of the following forms in the medical record will result in payment sent to the beneficiary? - Correct ️️ Assignme...

WHAT IS THE IMPORTANCE OF AUDIT IN A PRACTICE? - Correct ️️ 1. Reviewing quality of care provided to patients. 2. Educating providers on documentation. 3. Ensuring all services are supported and all appropriate revenue is captured. 4. Defending against external audit malpractice litigation an...

Which statement is true regarding an audit performed on charts for Medicare beneficiaries? - Correct ️️ National CMS policies and local MAC policies should be utilized when performing Medicare audits. In addition to CMS it is necessary to know your Medicare Administrative Contractor that supp...

Operation Restore Trust (ORT) - Correct ️️ * Two year partnership of federal and state agencies working together to protect the healthcare trust fund through shared intelligence and coordinated enforcement * Three agencies involved: The Office of the Inspector General (OIG), the Health Care ...

In the NCCI edits, what does modifier indicator nine (9) represent? A modifier may be used to bypass the edits if the documentation supports the modifier. B. A modifier is not allowed to bypass the NCCI edits. C. Only modifier 59 can be used to bypass the edi

In evaluation and management services, what does the A stand for in SOAP? What is included in this section? - Correct ️️ Assessment with diagnosis You are performing an audit of evaluation and management services for a family practice office. In the encounter, you read the physician order and...

CMS Fraud Definition - Answer ️️ Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - Answer ️️ An action that results in unnecessary costs to a federal healthcare program, either directly or i...

Accurate reimbursement begins with - Correct ️️ accurate coding and rules that vary by payer The CPT codebook contains - Correct ️️ instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - Corre...