CRCR STUDY QUESTIONS WITH COMPLETE SOLUTIONS GRADED A

code of conduct hospital establish compliance standards Purpose of OIG work plan? communicate issues that will be reviewed during the year for compliance with Medicare regulations 00:03 01:24 Medicare pt. admitted on Friday, what services fall within the three day window rule? Dx services and related charges provided on the W,R, and F before adm. What does modifier allow a provider to do? Report a specific circumstance that affected a procedure or service without changing the code or its definition Out pt. dx services provided within 3 days of adm. of a medicare benef. to an IPPS hospt, what must happen to these charges combined with the in pt. bill and paid under the MS-DRG system Why is OIG pursuing the medicare Secondary Payer reviews medicare payments for beneficiaries who have other insurance and assesses the effect. of procedures in preventing inappro. medcare payments for benef. with other ins. coverage Recurring or series registration? one reg. record is created for multi days of service Nonemergency pt. who comes for service w/out prior notif. to the provider called? unscheduled pt. stmnts apply to observ. pt. type used to evaluate the need for an in pt. adm. which services are hospice programs required to provide on an around the clock basis physician, nursing, pharmacy purpose of initial step in put pt. testing scheduling process identifying the correct pt. in the providers database or add the pt. to the database scheduler instructions are used to prompt the scheduler to do what? complete the scheduling process correctly based on service requested