NR 511 Week 1: Quiz REVIEW QUESTIONS AND ANSWERS

NR 511 Week 1: Quiz REVIEW QUESTIONS AND ANSWERS The phrase usual and customary refers to: The success rate of a specified procedure. How much an insurer will charge to provide coverage. Correct Answer How charges for a service compares with charges made to other persons receiving similar services and supplies. How an insurer evaluates the need for an ordered diagnostic test. The phrase usual and customary refers to the comparison of charges with other like charges for services and supplies received in the immediate vicinity as well as in a broader geographic area. What must you do as an advanced practice registered nurse (APRN) before billing for visits? Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer. Provide evidence of continuing medical education Obtain a Drug Enforcement Administration (DEA) number. Establish a collaborative agreement with a physician. To bill your clients for services, you must obtain a provider number and familiarize yourself with the rules and policies of each payor. Which one of the following is true regarding the importance of documentation? It allows you to communicate your findings to other providers and serves as a record for the visit. It is only important in order to bill the patient for your service. It is only important for defending yourself in the event of a law suit. It allows you to communicate your findings with the general public. The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family factors, positive and negative findings on physical exam and the provider's plan. Documentation is important for billing purposes, communication with other providers and in the case litigation.