Rvu components Study guides, Class notes & Summaries

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify 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 HMO Conventional PPO and POS H...

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...

Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - ANS b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the ...

What three components contribute to the calculation of Relative Value Units? Physician work, Practice expense, Malpractice insurance Rationale: Per the Centers for Medicare & Medicaid Services (CMS), Relative value units (RVUs) capture the following three components of patient care: Physician work RVU, Practice Expense RVU, and Malpractice RVUs. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? CPT® Category II codes Rationale: Per AM...

Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - b. Total RVU X Conversion factor = Medicare payment The total RVU is composed of which of the following ...

Modifiers - provide addtional info about the service/procedure indicating service/procedure has been altered but the definition of the code has not changed. Global Surgery Package - The time, effort, and services required to complete a procedure are bundled together to form a surgery package . Payment is made for a package of services and not each individual service provided within the package. Using RBRVS - CMS annually publishes Physician Fee Schedule information on its website and posts...

What three components contribute to the calculation of Relative Value Units? Physician work, Practice expense, Malpractice insurance Rationale: Per the Centers for Medicare & Medicaid Services (CMS), Relative value units (RVUs) capture the following three components of patient care: Physician work RVU, Practice Expense RVU, and Malpractice RVUs. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? CPT® Category II codes Rationale: Per AM...

AAPC CPB - Chapter 11 Review | Questions and Verified Solutions Latest Update 2024 Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer - b. Total RVU X...

AAPC CPB - Chapter 11 Pre-Test Questions 2024.Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - ANSWER b. Total RVU X Conversion factor = Medicare payment ...

RBRVS - ANSWER-Resource-Based Relative Value Scale RBRVS System - ANSWER-Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - ANSWER-Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - ANSWER-1) Physician work- time, skill, training, and intensity of service provided 2) P...