AND ANSWERS
Fee-for -service is a healthcare payment method in which
A. Physicians payments is determined
B. Skilled nursing facilities reimbursed is Determined
C. Providers received payment for services rendered
D. Claim denials are processed - Answer-C. Providers received payment for services
rendered
One of the purposes of the hospital payment monitoring program is to
A. Measure the outpatient payment error rate
B. Reduce necessary hospital admissions rate
C. Reduce the physician fee for service payment rate
D. Monitor and inpatient payment error rate - Answer-D. Monitor and inpatient payment
error rate
The UHDDS uses a minimum set of data elements based on:
A. Principles of reimbursement management
B. Hospital data collection
C. Data collected for outpatient services
D. Standard definitions used for consistent data - Answer-B. Hospital data collection
One of the purposes for physician query is to clarify
A. Conflicting documentation
B. Discharge instructions
C. Case management plans
D. Nursing care - Answer-A. Conflicting documents
One of the reasons the CMS developed the NCCI is to :
A. Control improper coding practices
B. Monitor medically unlike edits (MUE)
C. Correct improper use of modifier 59
D. Circumvent coding guidelines - Answer-A. Code improper coding practices
The UHDDS defines "other diagnoses " as
A. All conditions that developed after the time of admission
B. Conditions that should be reported based on hospital
C. Diagnosis that have no bearing on the present on the present ho
D. All conditions that coexist at the time of admission - Answer-C. Diagnosis that have
no bearing on the present
All general acute healthcare providers must report a Present on Admission (POA)
indicator. The purpose of reporting POA is to indicate conditions: