Rhia domain 4 - Study guides, Class notes & Summaries

Types of HMOs - Answer Group model HMO, independent practice association, network model HMO, staff model HMO PFFS - Answer You can see any doctor, other healthcare providers, or hospitals as long as they agree to treat you. The plan determines how much it will pay for services received SNP - Answer Plans for those with special needs such as: live in a nursing home, have both Medicaid and Medicare, have certain chronic medical conditions

Using the information provided, if the physician is a non-PAR who accepts assignment, how much can they expect to be reimbursed by Medicare? Physician's normal charge = $340 Medicare fee schedule = $300 Patient has met their deductible A. $228 B. $240 C. $285 D. $300 - Answer A. $228

RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified

RHIA DOMAIN 4 EXAM 2025 QUESTIONS AND CORRECT ANSWER

RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified

RHIA Domain 4 Exam | Questions And Answers Latest {} A+ Graded | 100% Verified

RHIA Domain 4 | Questions And Answers Latest {} A+ Graded | 100% Verified

What is the term for the set fee that a policyholder or certificate holder must periodically pay a health insurance plan in return for healthcare coverage? - Answer Premium All of the following occurrences are considered "qualifying life events" except: - Answer Car accident All of the following activities are steps in medical necessity and utilization review except: Initial clinical review

A patient has HIV with disseminated candidiasis. What is the correct code assignment? a. B20, B37.0 b. B37.7, B20 c. B20, B37.7 d. B20, B37.89, B37.7 correct answer: c Patients who are admitted for an HIV-related illness should be assigned a minimum of two codes in the following order: code B20 to identify the HIV disease and additional codes to identify the related diagnosis, which in this case is disseminated candidiasis code B37.7 A patient was admitted for removal of the left lobe of...

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