Rhia domain 4 test - Study guides, Class notes & Summaries

RHIA Domain 4 2024 Test Questions with Correct Answers What is coordination of benefits? - Answer-In many instances, patients have more than one insurance policy and the determination of which policy is primary and which is secondary is necessary so that there is no duplication in payment of benefits. This process is called coordination of benefits Data-mining efforts of recovery audit contractors (RAC) allow them to deny payments without ever reviewing a health record based on the informati...

A coder notes that the patient is taking prescribed Haldol. The final diagnoses on the progress notes include diabetes mellitus, acute pharyngitis, and malnutrition. What condition might the coder suspect the patient has that the physician should be queried to confirm? - Answer Mental or behavior problems In conducting a qualitative review, the clinical documentation specialist sees that the nursing staff has documented the patient's skin integrity on admission to support the presence of ...

RHIA Domain 4 Test with Compete Solutions Preliminary Step in Strategy Planning - Answer-Conduct an internal environment assessment Graph Analysis - Answer-Can only look at numbers, don't put in analysis for answers Rise in satisfaction after EHR - Answer-Don't assume it's bc of EHR, do more research Negatives of Using Mean - Answer-Influenced by outliers Errors in MPI - Answer-Billing Problems Due Diligence - Answer-Checking references Convenience Sample - Answer-Surveying...

Medicare Prescription Drug Plan: covers the cost of prescription drugs. Deductibles, cost, and coverage vary; the beneficiary pays a monthly premium, a deductible, and part of the cost of the drug. - Answer Medicare Part D __________ is a joint program of the federal and state government that provides health care for individuals who receive welfare, low-income pregnant women, and poor children. Each state determines qualification criteria, such as income levels, but the state must comply w...

In the APC system, a high-cost outlier payment is paid when which of the following occurs? a. The cost of the service is greater than the APC payment by a fixed ratio and exceeds the APC payment plus a threshold amount. b. The LOS is greater than expected. c. The charges for the services provided are greater than the expected payment. d. The total cost of all the services is greater than the sum of APC payments by a fixed ratio and exceeds the sum of APC payments plus a threshold amount. ...

Preliminary Step in Strategy Planning - Answer Conduct an internal environment assessment Graph Analysis - Answer Can only look at numbers, don't put in analysis for answers Rise in satisfaction after EHR - Answer Don't assume it's bc of EHR, do more research Negatives of Using Mean - Answer Influenced by outliers

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 AHIMA PRACTICE TEST EXAM 2024 WITH 100% CORRECT ANSWERS Processing - correct answer Domain 2 Classifying, sorting, storing and retrieving data are all characteristics of which system component? 1. Output 2. Feedback 3.Processing 4.Input K81.2, OFT40ZZ, OFJ44ZZ - correct answer Domain 1 The patient is taken to the OR for a laparoscopic gallbladder removal secondary to acute and chronic cholecystitis. The surgeon encounters difficulty secondary to the patients body habitus and ...

RHIA Domain 4 Practice Test with Complete Solutions A patient is admitted to the hospital with shortness of breath and congestive heart failure. The patient undergoes intubation with mechanical ventilation. The final diagnosis documented by the attending are: Congestive heart failure, mechanical ventilation, and intubation. Which of the following actions should the coder take in this case? - Answer-Query the attending physician as to the reason for the intubation and mechanical ventilation to...

RHIA Domain 4 Study Test Questions with Answers A CDI program facilitates accurate coding & helps coders avoid: A. NCCI edits B. Upcoding C. Coding without a complete face sheet D. Assumption coding - Answer-D. Assumption coding Which of the following is a governmental designation by the state that is necessary for the facility to offer services? A. Survey B. Licensure C. Certification D. Accreditation - Answer-B. Licensure Reviewing claims to ensure appropriate coding ...