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, "hold harmless clause" * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including: * more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a entity that processes nonstandard health information they receive from another
entity into a standard format
A key provision in HIPAA is the Minimum Necessary only the minimum necessary protected health information should be shared to
requirement. this means satisfy a particular purpose.
A medically necessary service is the least radical service/procedure that allows for effective treatment of the patients'
complaint or condition
A patient sustaining an injury to her great saphenous Leg
vein would have sustained injury to which of anatomical
site?
APC Ambulatory Payment Classification
ARRA American Recovery and Reinvestment Act (of 2009)
ASC Ambulatory Surgical Centers
Abuse consists of payment for items or services that are billed by providers in error that should not
be paid for by Medicare.
An ABN protects the provider's financial interest by creating a paper trail that CMS requires before a provider can bill the patient for
payment if Medicare denies coverage for the stated service or procedure.
An entity that processes nonstandard health information Clearinghouse
they receive from another entity into a standard format is
considered what?
As a part of Health Care Reform, the Affordable Care Act intent
of 2010 amended the definition of fraud to remove the
__________ requirement
By statute, all work RVUs, must be examined no less every 5 years
often than
CF Coversion Factor - fixed dollar amount used to translate the RVUs into fees
CMS Centers for Medicare and Medicaid