A four-digit code that describes a classification of a product or service provided to a patient is a - revenue code State Medicaid programs are required to offer medical assistance for - individuals with qualified financial need. Based on CMS's DRG system, other systems have been developed for paym...
rhia amp rhit final quiz 41 2022 complete solution
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RHIA & RHIT Final Quiz 4.1 2022 COMPLETE SOLUTION
A four-digit code that describes a classification of a product or service provided to a patient is a
Correct Answer: revenue code
State Medicaid programs are required to offer medical assistance for Correct Answer:
individuals with qualified financial need.
Based on CMS's DRG system, other systems have been developed for payment purposes. The
one that classifies the non-Medicare population, such as HIV patients, neonates, and pediatric
patients, is known as Correct Answer: APR-DRGs.
Which of the following best describes the situation of a provider who agrees to accept
assignment for Medicare Part B services? Correct Answer: The provider cannot bill the patients
for the balance between the MPFS amount and the total charges.
Terminally ill patients with life expectancies of ______ may opt to receive hospice services.
Correct Answer: 6 months or less
ICD-10-PCS procedure codes are used on which of the following forms to report services
provided to a patient? Correct Answer: UB-04
This is the amount collected by the facility for the services it bills. Correct Answer:
reimbursement
The Centers for Medicare and Medicaid Services (CMS) will make an adjustment to the MS-
DRG payment for certain conditions that the patient was not admitted with, but were acquired
during the hospital stay. Therefore, hospitals are required to report an indicator for each
diagnosis. This indicator is referred to as Correct Answer: present on admission.
____ is knowingly making false statements or representation of material facts to obtain a benefit
or payment for which no entitlement would otherwise exist. Correct Answer: fraud
A HIPPS (Health Insurance Prospective Payment System) code is a five-character alphanumeric
code. A HIPPS code is used by home health agencies (HHA) and ____. Correct Answer: skilled
nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs)
A patient is being cared for in his or her home by a qualified agency participating in Medicare.
The data-entry software used to conduct all patient assessments is known as Correct Answer:
HAVEN
Commercial insurance plans usually reimburse health care providers under some type of
__________ payment system, whereas the federal Medicare program uses some type of
_________ payment system. Correct Answer: retrospective, prospective
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