HFMA Study Guide Correctly Answered 2024

HFMA Study Guide Correctly Answered 2024 Through what document does a hospital establish compliance standards? - Answer -Code of Conduct What is the purpose of the OIG work plan? - Answer -Communicate issues that will be reviewed during the year for compliance with Medicare regulations If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - Answer -Diagnostic services and related charges provided on the Wednesday, Thursday and Friday before admission What does a modifier allow a provider to do? - Answer -Report a specific circumstance that affected a procedure or service without changing the code or its definition If outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges? - Answer -They must be combined with the inpatient bill and paid under the MS-DRG (diagnosis-related group) system Why is the OIG (Office of Inspector General) pursuing the Medicare Secondary Payer (MSP) initiative? - Answer -It reviews Medicare payments for beneficiaries who have other insurance and assesses the effectiveness of procedures in preventing inappropriate Medicare payments for beneficiaries with other insurance coverage What is a recurring or series registration? - Answer -One registration record is created for multiple days of service What are non-emergency patients who come for service without prior notification to the provider called? - Answer -Unscheduled patients Which of the following statements apply to the observation patient type? - Answer -It is used to evaluate the need for an inpatient admission Which services are hospice programs required to provide on an around-the-clock basis? - Answer - Physician, nursing, and pharmacy What is the purpose of the initial step in the outpatient testing scheduling process? - Answer -Identify the correct patient in the provider's database or add the patient to the