When billing medicaid - Study guides, Class notes & Summaries

NHA,CBCS | Questions and Verified Answers| 100% Correct| Grade A (2024/ 2025 Update) Q: A beneficiary of a Medicare/Medicaid crossover claim submitted by a participating provider is responsible for which of the following percentages? Answer: 0% Q: Which of the following coding manuals is used primarily to identify products, supplies, and services? Answer: HCPCS level II manual Q: A billing and coding specialist needs to know how much Medicare paid on a claim before b...

HFMA: Healthcare Financial Management Association Exam (2024 / 2025) Questions and Verified Answers 1. Which of the following options is an alternative to valid long-term payment plans? ~ Answer: Bank loans 2. What type of plan restricts benefits for nonemergency care to approved providers only? ~ Answer: A PPO (preferred provider organization) plan 3. What does scheduling allow provider staff to do? ~ Answer: Review the appropriateness of the service requested 4. When an adult patient is covere...

Types of prevention - answer-primary- car restraints, bicycle helmets, immunizations secondary- prevent for those with RF-pap, mammo tertiary-mgmt of established disease- meds, lifestyle Primary - answer-Preventing the health problem, most cost effective form of healthcare **IMMUNIZATIONS, ensuring adequate illumination at home (preventing falls) Secondary - answer-Detecting disease in early asymptomatic stages, screenings -Early cause finding of asymptomatic disease via the use of a sc...

NP Role Final Exam 159 Questions with Verified Answers In which specialty are most nurse practitioners educated? Peds Primary care Family Adult gerontology - CORRECT ANSWER primary care Which factor represents a potential barrier to Nurse Practitioner's practice in a primary care setting? Cost effectiveness Professional growth Aging baby boomers Collaboration agreements - CORRECT ANSWER Collaboration agreements Distinguish among the advanced practice registered nursing (APRN...

True or False: The profession of physical therapy will not be affected by the full enactment of the Affordable Care Act (ACA). - False, the ACA will have affect on reimbursement of medicare and medicaid True or False: Undocumented immigrants are covered by the Affordable Health Care Act. - False What was the date for the final step of the Affordable Health Care Act to begin? - New Years Day 2014 True or False: When billing for Medicare, it doesn't matter what part of the country the provi...

DME refers to _______________ includes crutches and wheelchairs durable medical equipment _____ was implemented to control cost of inpatient care and was implemented by CMS PPS centers for medicare and medicaid services CMS _________________ should consider all except billing the patient insurance specialists When are hospitals to report actual charges for in-patient care to payers after discharge ______________ are associated with a particular category of inpatient and are established by ...

Medical Billing & Coding as a Career - Answer *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - Answer Standards of conduct based on moral principle. They are generally accepted as a guide for behavior towards pt's, dr's, co-wo...

NCCT Practice Test 2 Billing and Coding Real Exam 2024 Already Passed. CPT codes are - ANSWER ==5 digits An organization which provides a wide range of services for a specified group at a fixed periodic payment is termed an - ANSWER ==HMO TBSA refers to: - ANSWER ==Total body surface area There are two types of CPT codes, stand alone and: - ANSWER ==Indented Codes Services in which opinions of specialists are requested, are called: - ANSWER ==Consultations Examples of HCPCS Level II code...

NCCT Practice Test 2 Billing and Coding Real Exam 2024 Already Passed. CPT codes are - ANSWER ==5 digits An organization which provides a wide range of services for a specified group at a fixed periodic payment is termed an - ANSWER ==HMO TBSA refers to: - ANSWER ==Total body surface area There are two types of CPT codes, stand alone and: - ANSWER ==Indented Codes Services in which opinions of specialists are requested, are called: - ANSWER ==Consultations Examples of HCPCS Level II code...

CMS Fraud Definition - Answer- Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition - Answer- An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud - Answer- Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a higher payment amount, billing a M...