Exam (elaborations)
RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified
- Course
- Institution
RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified
[Show more]
Content preview
RHIA Domain 4 Exam | Questions And Answers Latest {2024- 2025} A+ Graded | 100%Verified
APC acronym - Ambulatory Patient Classification
APC is used in place of _____ for outpatient prospective systems - DRGs
APG acronym - Ambulatory Patient Groups
Visit based outpatient classification system designed to explain the amount and type of resources used
in the ambulatory setting - APG
Rule requiring Medicare to bundle all outpatient services provided by a hospital to a patient within three
days before admission into the DRG payment for that patient - three day payment window
Payment status indicators are assigned to every ______ code - HCPCS/CPT
an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
- sentinel event
_____________ was developed based on a federal mandate to Medicare to stop paying for conditions
that hospitals cause or allow to develop during inpatient stays. - POA indicator
Preventable medical error resulting in serious consequences for the patient. - Never events
MS-DRG acronym - Medicare Severity Diagnosis Related Groups
How many major diagnostic categories are there? - 25
Part of Medicare that pays for inpatient care, skilled nursing facility care, skilled home healthcare, and
hospice care - A
, Part of Medicare that pays for physician services, outpatient hospital services, medical equipment, and
other supplies and services - B
Part of Medicare that private health insurance companies contract with CMS to offer Medicare
beneficiaries Medicare Advantage plans that compete with the Original Medicare Plan - C
MMA acronym - Medicare Modernization Act
Part of Medicare that is authorized under the MMA and provides voluntary Medicare prescription drug
plans that are open to people who are eligible for Medicare - D
Difference between Medicare and Medicaid - Medicare is a federal program that provides health
coverage if you are 65 or older or have a severe disability, no matter your income. Medicaid is a state
and federal program that provides health coverage if you have a very low income.
Government contractor that processes claims - fiscal intermediary
Where is CMS headquartered? - Baltimore, Maryland
MACs acronym - Medicare Administrative Contractors
Contractor who handles claims and related functions for Part A and B - MACs
MPFS acronym - Medicare Physician Fee Schedule
Medicare Physician Fee Schedule amounts are ___ percent higher than for nonparticipating providers - 5
Decisions by MACs about the coding and medical necessity of a service - LCD
Policy stating whether and under what circumstances a service is covered - NCD
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller oneclass. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.48. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79271 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now