Overall aggregate payments made to a hospice are subject to a computed "cap
amount" calculated by - ANSWER-The Medicare Administrative Contractor
(MAC) at the end of the hospice cap period
Which of the following is required for participation in Medicaid - ANSWER-
Meet Income and Assets Requirements
In choosing a setting for patient financial discussions, organizations should first
and foremost - ANSWER-Respect the patients privacy
A nightly room charge will be incorrect if the patient's - ANSWER-Transfer 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 - ANSWER-Purchase
qualified health benefit plans regardless of insured's
health status
,A portion of the accounts receivable inventory which has NOT qualified for
billing includes: - ANSWER-Charitable pledges
What is required for the UB-04/837-I, used by Rural Health Clinics to generate
payment from Medicare? - ANSWER-Revenue 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 - ANSWER-Patient 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 - ANSWER-Case management
Which statement is an EMTALA (Emergency Medical Treatment and Active
Labor Act) violation? - ANSWER-Registration 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 - ANSWER-The Internal Revenue Service
Checks received through mail, cash received through mail, and lock box are all
examples of - ANSWER-Control points for cash posting
What are some core elements if a board-approved financial assistance policy? -
ANSWER-Eligibility, application process, and nonpayment collection activities
, A recurring/series registration is characterized by - ANSWER-The 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 - ANSWER-Assist patients in understanding their insurance
coverage and their financial obligation
The purpose of a financial report is to: - ANSWER-Present financial information
to decision makers
Patient financial communications best practices produce communications that
are - ANSWER-Consistent, clear and transparent
Medicare has established guidelines called the Local Coverage Determinations
(LCD) and National Coverage Determinations (NCD) that establish - ANSWER-
What 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 - ANSWER-The Provider Reimbursement Review
Board
Concurrent review and discharge planning - ANSWER-Occurs during service
Duplicate payments occur: - ANSWER-When providers re-bill claims based on
nonpayment from the initial bill submission
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