REVENUE CYCLE MANAGEMENT
QUESTIONS AND ANSWERS (GRADED
A+)
The supervision of all administrative and clinical functions that contribute to the capture,
management, and collection of patient service revenue. - ANSWER-Revenue Cycle
Management (RCM)
discharged not final billed - ANSWER-DNFB
Promotes cooperation,communication, and education - ANSWER-Multiple Disciplinary
Approach
Preclaims submission activities
Claims processing
Accounts receivable
Claims reconciliation and collection - ANSWER-Components of the revenue cycle
procedures that ensure billable services are recorded and reported for payment -
ANSWER-Charge Capture
Database used by healthcare facilities to house the price list for all services provided to
patients. - ANSWER-Charge Description Master (CDM)
Hospital Issued Notice of Non coverage - ANSWER-HINN
Advanced Beneficiary Notice - ANSWER-ABN
Pre-admission/Admission
HRR/HINN 10
HINN 11
HINN 12 - ANSWER-The four HINN's hospitals issue
when an item or service is not reasonable and medically necessary under the Medicare
Program standards (ie. experimental, investigational, research only, not safe or
effective) - ANSWER-ABNs and HINNs are issued
National Coverage Determinations - ANSWER-NCDs
Incompatible dates of service
Nonspecific or inaccurate diagnosis and procedure codes
Lack of medical necessity
QUESTIONS AND ANSWERS (GRADED
A+)
The supervision of all administrative and clinical functions that contribute to the capture,
management, and collection of patient service revenue. - ANSWER-Revenue Cycle
Management (RCM)
discharged not final billed - ANSWER-DNFB
Promotes cooperation,communication, and education - ANSWER-Multiple Disciplinary
Approach
Preclaims submission activities
Claims processing
Accounts receivable
Claims reconciliation and collection - ANSWER-Components of the revenue cycle
procedures that ensure billable services are recorded and reported for payment -
ANSWER-Charge Capture
Database used by healthcare facilities to house the price list for all services provided to
patients. - ANSWER-Charge Description Master (CDM)
Hospital Issued Notice of Non coverage - ANSWER-HINN
Advanced Beneficiary Notice - ANSWER-ABN
Pre-admission/Admission
HRR/HINN 10
HINN 11
HINN 12 - ANSWER-The four HINN's hospitals issue
when an item or service is not reasonable and medically necessary under the Medicare
Program standards (ie. experimental, investigational, research only, not safe or
effective) - ANSWER-ABNs and HINNs are issued
National Coverage Determinations - ANSWER-NCDs
Incompatible dates of service
Nonspecific or inaccurate diagnosis and procedure codes
Lack of medical necessity
