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Reimbursement and HIPAA

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Question
Answer
show False. Next business day.  
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show False. Clearinghouses, Providers and Third party payers are "Covered Entities".  
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Insurance companies are rated according to the number of complaints received about them.   show
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When a physician offers a discount, it must apply to the total bill, not just the portion that is paid by the patient.   show
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show False.  
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show False. Perception on part of the family is that an element of guilt is implied.  
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show True.  
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show False. Based on Procedures.  
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A patient always has the right to obtain a copy of his/her confidential health information.   show
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A collection rate of 80-85% should be a goal for the practise administrator in charge of collections in the physician's office.   show
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show True.  
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show True.  
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The purpose of the DRG based system is to hold down rising health care costs.   show
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show True.  
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show False. It is the Conversion Factor.  
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Confidential data should be stored only in the computer's hard drive.   show
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show True.  
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If the provider is notified by a commercial carrier that an overpayment has been made, investigate the refund request.   show
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When a physician continues to treat an established patient with an overdue account, patients who fall into this delinquent status should be referred elsewhere.   show
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show False. Volume 1 and 2 only in the private office.  
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show All the above.  
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M/C: The claim form transmitted to the insurance carrier for reimbursement for inpatient hospital services is called?   show
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M/C: A group of insurance claims sent at the same time from one facility is known as a:   show
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The most important function of a practise management system is:   show
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show All the above.  
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show Carrier-direct  
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The significant reason for which a patient is admitted to the hospital is coded using the:   show
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show Detailed or itemized statement.  
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Nonprivilged information about a patient consists of the patient's:   show
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show HIPAA Title II Adminstrave Simplification.  
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show Have the physician return the phone call.  
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The rule stating that when a patient receives outpatient services within 72 hours of admission, then all outpatient services are combined with inpatient services and become part of the diagnostic-related group for the admission, is called the____?   show
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show Hospital consultations; Hospital visits; Emergency department visits.  
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Pending or resubmitted insurance claims may be tracked through a_______?   show
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show EOB (Explanation of Benefits)  
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An example(s) of a technical error on an insurance claim is?   show
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The correct method to send documents for a Medicare reconsideration (Level 2) is by what method?   show
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The average amount of accounts receivable should be?   show
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show Fair Debt Collection Practises Act (FDCPA)  
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show Relative Value Unit  
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show Pre Admission Testing  
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What does CCI stand for?   show
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show Diagnosis Related Group  
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What does APC stand for?   show
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show Resource Based Relative Value Scale(System)  
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What does GAF stand for?   show
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What does UCR stand for?   show
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show Health Level 7  
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What does EIN stand for?   show
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show Encryption  
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show Back-up  
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If the medical practise receives payment from an insurance company that is more than the contracted rate, it is called a/an ____?   show
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show Appeal  
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The relationship of the amount of money owed to a physician and the amount of money collected on the physician's accounts receivable is called the _____?   show
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show Physical  
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show Utilization Review.  
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A 3 to 4 digit code representing a specific accomodation ancillary service or billing calculations related to a service is a/an?   show
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show Diagnosis and Treatment  
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show Customary (UCR)  
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Stealing money that has been entrusted to one's care is known as?   show
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Billing for services or supplies not provided is?   show
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show Abuse  
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The procedure of systematically arranging the accounts receivable by age from the date of service is called?   show
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show Dun  
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show Statue of Limitations.  
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show Executor  
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A/an _____ is a claim on the property of another as seurity for a debt.   show
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show Annually  
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show Statue of Limitation  
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show UB-04; CMS 1450; 837i  
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Explain the following formula. Not only what the abbrevations stand for, but also their meaning: RVU X GAF X CF= MEDICARE REIMBURSEMENT   show
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show Verbal warning; Written warning; Written reprimand; Suspension or probation; Demotion; Termination; Restitution of damages; Referral for prosecution.  
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show Health Insurance Portability and Accountablity Act. (1996 signed into law by Pres. Clinton)  
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