The disadvantages of outsourcing include all of D
the following EXCEPT:
a) The impact of customer service or patient
relations
b) The impact of loss of direct control of accounts
receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance
on outsourced staff
The Medicare fee-for service appeal process for B
both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent
physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles
claims for
Medicare
d) Review by the Medicare Appeals Council
(Appeals Council)
,Business ethics, or organizational ethics represent: A
a) The principles and standards by which
organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct
A portion of the accounts receivable inventory A
which has NOT qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but
not activated
c) Accounts coded but held within the suspense
period
d) Accounts assigned to a pre-collection agency
,Local Coverage Determinations (LCD) and C
National Coverage Determinations (NCD) are
Medicare established guideline(s) used to
determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are
reimbursable
d) What Medicare reimburses and what should be
referred to
Medicaid
Days in A/R is calculated based on the value of: C
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date
, Patients are contacting hospitals to proactively B
inquire about costs and fees prior to
agreeing to service. The problem for hospitals in
providing such information is:
a) That hospitals don't want to establish a price
without knowing if
the patient has insurance and how much
reimbursement can be
expected
b) The fact that charge master lists the total
charge, not net charges
that reflect charges after a payer's contractual
adjustment
c) That hospitals don't want to be put in the
position of
"guaranteeing" price without having room for
additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary
information
the following EXCEPT:
a) The impact of customer service or patient
relations
b) The impact of loss of direct control of accounts
receivable services
c) Increased costs due to vendor ineffectiveness
d) Reduced internal staffing costs and a reliance
on outsourced staff
The Medicare fee-for service appeal process for B
both beneficiaries and providers
includes all of the following levels EXCEPT:
a) Medical necessity review by an independent
physician's panel
b) Judicial review by a federal district court
c) Redetermination by the company that handles
claims for
Medicare
d) Review by the Medicare Appeals Council
(Appeals Council)
,Business ethics, or organizational ethics represent: A
a) The principles and standards by which
organizations operate
b) Regulations that must be followed by law
c) Definitions of appropriate customer service
d) The code of acceptable conduct
A portion of the accounts receivable inventory A
which has NOT qualified for billing
includes:
a) Charitable pledges
b) Accounts created during pre-registration but
not activated
c) Accounts coded but held within the suspense
period
d) Accounts assigned to a pre-collection agency
,Local Coverage Determinations (LCD) and C
National Coverage Determinations (NCD) are
Medicare established guideline(s) used to
determine:
a) Medicare and Medicaid provider eligibility
b) Medicare outpatient reimbursement rates
c) Which diagnoses, signs, or symptoms are
reimbursable
d) What Medicare reimburses and what should be
referred to
Medicaid
Days in A/R is calculated based on the value of: C
a) The total accounts receivable on a specific date
b) Total anticipated revenue minus expenses
c) The time it takes to collect anticipated revenue
d) Total cash received to date
, Patients are contacting hospitals to proactively B
inquire about costs and fees prior to
agreeing to service. The problem for hospitals in
providing such information is:
a) That hospitals don't want to establish a price
without knowing if
the patient has insurance and how much
reimbursement can be
expected
b) The fact that charge master lists the total
charge, not net charges
that reflect charges after a payer's contractual
adjustment
c) That hospitals don't want to be put in the
position of
"guaranteeing" price without having room for
additional charges
that may arise in the course of treatment
d) Their reluctance to share proprietary
information
