837p Study guides, Class notes & Summaries

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided b...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

according to CPT, a repair of a laceration that includes retention sutures would be considered what type of closure? complex closure identify the 2 digit modifier that may be reported to indicate a doctor performed the postoperative management of a patient, but ANOTHER doctor performed the surgical procedure: -55 according to the QHDDS, what is the definition of "other diagnoses"? "other diagnoses" is interpreted as additional conditions that affect patient care in terms of ...

CRCS - ANSWER Certified Revenue Cycle Specialist AAHAM - ANSWER The American Association of Healthcare Administrative Management 1-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within one day prior to the hospital admission are bundled with the inpatient services for Medicare billing. 3-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the p...

CRCS correct answer: Certified Revenue Cycle Specialist AAHAM correct answer: The American Association of Healthcare Administrative Management 1-Day Rule correct answer: a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within one day prior to the hospital admission are bundled with the inpatient services for Medicare billing. 3-Day Rule correct answer: a requirement that all diagnostic or outpatient services fu...

AAHAM CRCS-P Study Questions with Correct Answers CRCS - Correct Answer ️️ -Certified Revenue Cycle Specialist AAHAM - Correct Answer ️️ -The American Association of Healthcare Administrative Management 1-Day Rule - Correct Answer ️️ -a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within one day prior to the hospital admission are bundled with the inpatient services for Medicare billing. 3-Day Rule - Corr...

3-Day Rule - ANSWER Medicare regulation requiring that certain outpatient services within 72 hours of an inpatient admission must be included in the patient's inpatient claim and reimbursed under a DRG. 8371 - ANSWER HIPAA standard transaction used by hospitals to submit claims electronically. 837P - ANSWER HIPAA standard transaction that replaces the 1500 and is required of almost all physicians. 838 - ANSWER quarterly Medicare Credit Balance Report 1450 - ANSWER CMS 1450 form; ano...

CRCS - ANSWER Certified Revenue Cycle Specialist AAHAM - ANSWER The American Association of Healthcare Administrative Management 1-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within one day prior to the hospital admission are bundled with the inpatient services for Medicare billing. 3-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the p...

3-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within three days prior to the hospital admission are bundled with the inpatient services for Medicare billing 837I - ANSWER the American National Standards Institute transaction for an institutional claim; as a result of HIPAA, it is replacing the electronic UB-04. 837P - ANSWER a former American National Standards Institute transaction for a professi...

CHDA Domain 2 (Data Acquisition and Management) Questions and Answers 100% Solved An audit tracking DB would contain information from the health care claim payment advice that is in what format? ️️835 (originally payment and remittance advice was one transaction, the ASC X12 835 Payment and Remittance Advice, which supplied information about what payment was made on which claims) Data showing a physician's professional fee charges would be found on which billing format? ️️...