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1 of 202
Term
An individual enrolled in Medicare who is dissatisfied with the
government's claim determination is entitled to reconsideration of
the decision. This type of appeal is known as
A clean claim A beneficiary appeal
Contracted Rebating A medicare determination appeal
, 2 of 202
Term
Days in A/R is calculated based on the value of:
The time it takes to The time it takes to
collect anticipated process insurance claims
revenue
The delay in receiving medical The period for auditing financial
supplies records
3 of 202
Term
The purpose of the ACA mandated Community Health Needs
Assessment is
Reduced internal staffing costs and
Final bill is presented for payment a reliance on outsourced staff
, To identify significant health
needs, prioritize those needs Ensure that she/he accesses the
and identify resources to correct information in the historical
address them database
4 of 202
Term
Case Management requires that a case manager be assigned
To all patients regardless of
condition To a select patient group
To patients seeking routine To patients with chronic dental
check- ups issues
5 of 202
Term
Across all care settings, if a patient consents to a financial discussion
during a medical encounter to expedite discharge, the HFMA best
, practice is to:
Support the choice, provided it Encourage the choice, ensuring
occurs after discharge immediate payment
Support that choice, providing
that the discussion does not Discourage the choice, prioritizing
interfere with patient care medical assessment
or disrupt patient flow
6 of 202
Term
It is important to calculate reserves to ensure
Stable financial operations
and accurate financial Increased patient volume and
reporting higher revenue generation