Third party payer Study guides, Class notes & Summaries

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED What are collection agency fees based on? - CORRECT ANSWER-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER-Case rates What customer service improvements might improve the patie...

EDF 6557 Ethics Final Exam 2023 with 100% correct answers 1. Which of these is not one of the 10 sections of the BACB's Professional and Ethical Compliance Code for Behavior Analysts?: Ethical Responsibility to Supervisors 2. Code element 1.01 discusses reliance on scientific knowledge. Which of the following describes behavior adhering to this code element:: All of the above 3. On what sources should behavior analysts base their practices?: A and B 4. Amy spends extra time with her cli...

Customer service impressions are formed by the staff's ______ and _______ towards them. - ANSWER-attitude and behavior _______ may be any patient, family member, visitor, physician, other hospital, personnel, third party payer, vendors, suppliers, etc. - ANSWER-Customers Internal customers are people in other _______ , fellow ______, management, information services, etc. within the __________ who all work together in caring for the patient. - ANSWER-departments, employees, organization ...

Knowing which of the following can best assist a technician in the prevention of data entry errors? A. Names of medications B. Insurance co-payments C. Pharmacokinetics D. Physician contact information - correct answerA. Names of medications Which of the following injectable drugs would be stored in refrigerator? A. Clindamycin B. Ciprofloxacin C. Cyanocobalamin D. Calcitonin-salmon - correct answerD. Calcitonin-salmon The requirement that a non-formulary medication be covered ...

Management functions correct answers key functions of a manager including planning, organizing, staffing, directing & controlling Management connective processes correct answers mgmt functions that connect elements of the healthcare org. including communicating, coordinating and decision making Joint Commission correct answers primary accrediting organization for healthcare orgs. Healthcare Financial Mgmt Association (HFMA) correct answers Association of healthcare financial managers; c...

NCCT NCMA Practice Test - Part 3 Questions and Answers a - Answer-A bed patient in a hospital is called a(n) __________. a. inpatient b. outpatient c. third party payer d. provider b - Answer-A person who represents either party of an insurance claim is the ___________. a. doctor b. adjuster c. provider d. subscriber b - Answer-A request for payment under an insurance contractor bond is called a(n) _____________________. a. insurance application b. claim c. dual choice request ...

In health care payment systems, ________ is a more recent method of paying an organization, in which the third party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client a. Retrospective reimbursement b. Prospective reimbursement c. Health Maintenance Organization (HMO) d. Preferred Provider Organization (PPO) Correct Answer-b. Prospective reimbursement Which statements are true? Select all that apply C...

CCA Exam Prep Domain 2 (2023/2024) Rated A+ Allowable fee Average or maximum amount the third-party payer will reimburse providers for the service Block grant It is a fixed amount of money given or allocated for a specific purpose. Ex. Medicare's payment system for home health services are consolidated into the single payment Capitated payment method It is a method of payment for health services in which the thirdparty payer reimburses providers a fixed, per capita amount for a period. "...

NHA,CBCS Exam (New 2024/ 2025 Update) |Questions and Verified Answers| 100% Correct| A Grade QUESTION Which of the following formats are used to submit electronic claims to a third-party payer? Answer: 837 QUESTION Urine moved from the kidneys to the bladder through which of the following parts of the body? Answer: Ureters QUESTION As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a further...

Abuse - Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. Accounts Receivable Management -...