Practice expense rvu - Study guides, Class notes & Summaries

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

"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 entity that processes nonstandard health infor...

RBRVS correct answersResource-Based Relative Value Scale RBRVS System correct answersEstablished by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU correct answersEach 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 correct answers1) Physician work- time, skill, training, and intensity of ...

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) Practice Expense - reflects the cost of ancillary personnel, supplies, and overhead 3) Professional Liability Malpractice Insurance Using RBRVS - ANSWER-CMS annually publishes Physician Fee Schedule information on its website and posts the fo...

What is an example of a quality assessment tool? Process map, run chart, Pareto diagram, decision matrix, etc. What is the main purpose of a strategic plan? To develop long range objectives and goals. What is a "just in time" inventory process? Supplies arrive when you are ready to use them. Which federal agency is responsible for regulating workplace safety? Occupational Safety and Health Administration (OSHA) What should a medical practice complete to allow an...

CDEO Chapter 7 Exam Study Guide with Complete Solutions RBRVS - Answer️️ -Resource-Based Relative Value Scale RBRVS System - Answer️️ -Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - Answer️️ -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 - Answer️️ -...

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 - correct answer b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of...

Review for CPB Exam Practice Questions and Answers To report co-management, Which below must be true? - ANSWER-A. Co-management only applies to doctors in the same clinic. B. Two physicians must be performing the surgical procedure. C. Two doctors must be managing the Post-op Care. D. Non of the answers are correct. Answer: D None of the answers are correct. The doctors must be in separate office/clinics. Co- management refers to another provider providing the post-operative care for a s...

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 Conversion factor = Medicare payment The total RVU is composed of which of the fo...

AAPC CPB - Chapter 11 Review Questions and Answers |100% Pass 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 Conversion factor = Me...