MAP 114 final exam questions with verified solutions

MAP 114 final exam questions with verified solutions DME refers to _______________ includes crutches and wheelchairs durable medical equipment _____ was implemented to control cost of inpatient care and was implemented by CMS PPS centers for medicare and medicaid services CMS _________________ should consider all except billing the patient insurance specialists When are hospitals to report actual charges for in-patient care to payers after discharge ______________ are associated with a particular category of inpatient and are established by the payer prospective price based rates these do not decrease the practices patient base managed care contracts How many people are covered by some kind of insurance ___ in the US 85% documentation submitted to an insurance plan requesting reimbursement for services provided by provider claim what payment system includes CHAMPVA, medicaid and medicare federal established payment system for ambulance services for Medicare beneficiaries ambulance fee services home health prospective payment system established: reimbursement rates for ___ days 60 what are divided into these three components: work + practice expense + malpractice RVUs DHHS Department of Health and Human Services process of reporting diagnoses, procedure, and service as numeric and alphanumeric characters on insurance claims forms coding what are the levels of coding: _______ , ________ and level three was phased out CPT and HCPCS a claim is ______ to the patient if the 3rd party payer denies due to non-covered services billed skills of _____ include: knowledge of anatomy, physiology, and medical terminology HIS _________ of HIS do not include calling the patient concerning prescriptions responsibilities GAF, payment limits are also established by adjusting the RVU's for each locality geographic adjustment factors a particular diagnosis may not have received direct treatment during the visit but it affect what the provider does and must be considered medically managed S in SOAP subjective O in SOAP objective A in SOAP assessment