Q1
What are collection agency fees based on?
Answer: A percentage of dollars collected
Q2
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what
other rule?
Answer: Birthday
Q3
In what type of payment methodology is a lump sum or bundled payment negotiated between
the payer and some or all providers?
Answer: Case rates
Q4
What customer service improvements might improve the patient accounts department?
Answer: Holding staff accountable for customer service during performance reviews
Q5
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?
Answer: Inform a Medicare beneficiary that Medicare may not pay for the order or
service
Q6
What type of account adjustment results from the patient's unwillingness to pay for a self-pay
balance?
Answer: Bad debt adjustment
Q7
What is the initial hospice benefit?
Answer: Two 90-day periods and an unlimited number of subsequent periods
, Q8
When does a hospital add ambulance charges to the Medicare inpatient claim?
Answer: If the patient requires ambulance transportation to a skilled nursing facility
Q9
How should a provider resolve a late-charge credit posted after an account is billed?
Answer: Post a late-charge adjustment to the account
Q10
What is an advantage of a preregistration program?
Answer: It reduces processing times at the time of service
Q11
What are the two statutory exclusions from hospice coverage?
Answer: Medically unnecessary services and custodial care
Q12
What core financial activities are resolved within patient access?
Answer: Scheduling, insurance verification, discharge processing, and payment of
point-of-service receipts
Q13
What statement applies to the scheduled outpatient?
Answer: The services do not involve an overnight stay
Q14
How is a mis-posted contractual allowance resolved?
Answer: Comparing the contract reimbursement rates with the contract on the
admittance advice to identify the correct amount