Ffs fee for service - Study guides, Class notes & Summaries

12.1% - ANSWER # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - ANSWER Fee-For-Service Prepayment Review - ANSWER Review of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment Review - ANSWER Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. Underpayment - ANSWER A payment a provider recei...

AHIP Final Exam Test Questions and Answers (2024/2025) (Verified Answers)GRADED A LATEST VERSION Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-...

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney tran...

Under the broad category of fee-for-service (FFS), what are the three main types of fee-for- service methodologies that were discussed in class? -Cost-Based -Charge-Based -Prospective Payments Select all of the TRUE statements about ICD Codes. -The greater the number of digits in the code, the more detailed the disease. -The codes currently consist of 3, 4, 5, 6, or 7 digits/characters -ICD- stands for International Classification of Diseases -ICD-10 is the current standard

AHIP ACTUAL TEST QUESTIONS AND ANSWERS 2024 WITH COMPLETE SOLUTION |PASS IN FIRST ATTEMPT UNIT 1 Medicare Basics Question 1 Mr. Buck has several family members who died from different cancers. He wants to know if Medicare covers cancer screening. What should you tell him? a. Medicare covers all screening tests that have been approved by the FDA on a frequency determined by the treating physician. b. Medicare covers treatments for existing disease, injury, and malformed limbs or body part...

Chapter 1 CPMA Exam Prep Questions And Answers 12.1% - ANS # of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFS - ANS Fee-For-Service Prepayment Review - ANS Review of claims prior to payment. Prepayment reviews result in an initial determination. Post Payment Review - ANS Review of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. ...

IPPS - ANSWERinpatient prospective payment system OPPS - ANSWEROutpatient Prospective Payment System fee-for-service (FFS) - ANSWERa written fee schedule for each treatment and/or service provided MS-DRG - ANSWERMedicare Severity Diagnosis Related Group Case-Mix Index (CMI) - ANSWERthe average relative weight of all patients treated at a specific facility or by a specific physician to measure clinical severity or resource utilization Ambulatory patient classifications (APC) - AN...

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. Mr. Davis is 52 years old and ha...

AHIP Exam Questions and Answers 100% Pass Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? - Correct Answer ️️ -Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease and Lou Gehrig's disease,...

AHIP MEDICARE TRAINING 2024 PRACTICE QUESTIONS AND ANSWERS 100% PASS Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for- Service" plans. She wants to know what the difference is if any. What should you tell her? - Correct Answer ️️ -PFFS plans are a type of Medicare Advantage plan offered by private companies. This year you decide to focus your efforts on marketing to employer and union groups. Which of the following statements best describes what...