Crcr exam 2024 stuvia - Study guides, Class notes & Summaries

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What do Case Managers do? - ANSWER-Monitor high resource cases to ensure effective utilization What is HIM responsible for? - ANSWER-all pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? - ANSWER-manage cases: services correct, on time What are the three types of utilization review? - ANSWER-Prospective, Concurrent, Retrospective Where can home health services be offered? - ANSWER-Home, Assist ...

Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - ANSWER - The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - ANSWER - Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - ANSWER - Respect the patients privacy A nightly room charge will be incorrect if the pa...

Through what document does a hospital establish compliance standards? - ANSWER - code of conduct What is the purpose OIG work plant? - ANSWER - Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - ANSWER - Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? - ANSWER - Report a specific circumstance that affected a proce...

Through what document does a hospital establish compliance standards? - ANSWER-code of conduct What is the purpose OIG work plant? - ANSWER-Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - ANSWER-Non-diagnostic service provided on Tuesday through Friday What does a modifier allow a provider to do? - ANSWER-Report a specific circumstance that affected a procedure or ...