Rvu Study guides, Class notes & Summaries

What three components contribute to the calculation of Relative Value Units? Physician work, Practice expense, Malpractice insurance Rationale: Per the Centers for Medicare & Medicaid Services (CMS), Relative value units (RVUs) capture the following three components of patient care: Physician work RVU, Practice Expense RVU, and Malpractice RVUs. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? CPT® Category II codes Rationale: Per AM...

AAPC Official CPC Certification Study Guide Notes "hold harmless clause" - Answer ️️ -* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - Answer ️️ -* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing h...

# 1 According to the ACHE’s Code of Ethics, one way that healthcare executives can avoid or minimize the negative implications of conflict of interest is to: Make the conflict known to those in superior positions. #2 The principles of quality improvement require that healthcare executives change their management philosophy from: Finding fault with employees to finding problems in processes. #3 What type of problem arises when a healthcare executive knowingly allows the o...

AAPC Official CPC Certification Study Guide Notes "Hold harmless clause" - answer* found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - answer* more accurate payment of claims * fewer billing mistakes * improved documentation and more accurate coding * less chance of violating self-referral and anti-kickback status A healthcare clearing house is a - answer...

CPB Practice Exam A The office policy for claims follow-up is to prioritize the insurance balance accounts past 90 days by highest outstanding balance. Based on the A/R report provided, which payer type and aging category would be one of the top priorities on which to focus collection efforts? - workers' compensation, 121+ days Using the fee schedule and the payment policy provided, what is the expected reimbursement (including patient responsibility) when a provider performs a nasal ...

FACHE - ACHE BOG EXAM SAMPLE TEST QUESTIONS - HEALTHCARE WITH COMPLETE SOLUTION Which of the following si true about a capitated Managed Care Organization (MCO) arrangement: a) The provider shifts financial risk to the MCO b) The provider can bil separately for each service provided c) The provider must wait to bil the MCO until services have been provided to a patient d) The provider is paid a set fee - ANSWER-d) The provider is paid a set fee Which of the following is a unit of me...

What three components contribute to the calculation of Relative Value Units? Physician work, Practice expense, Malpractice insurance Rationale: Per the Centers for Medicare & Medicaid Services (CMS), Relative value units (RVUs) capture the following three components of patient care: Physician work RVU, Practice Expense RVU, and Malpractice RVUs. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? CPT® Category II codes Rationale: Per AM...

According to the Code of Ethics, one way executives can avoid or minimize negative implications of conflict of interest is: a) develop a PR plan to address conflict of interest scenarios b) not participate in specific decisions where conflict may exist c) ensure members submit annual holdings for inspection d) make the conflict known to those in superior positions - D The principles of quality improvement require that executives change their management philosophy from: A) finding fault w...

RBRVS - ANSWER-Resource-Based Relative Value Scale RBRVS System - ANSWER-Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - ANSWER-Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - ANSWER-1) Physician work- time, skill, training, and intensity of service provided 2) P...

AAPC CPB - Chapter 11 Review | Questions and Verified Solutions Latest Update 2024 Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer - b. Total RVU X...