CCA EXAM PREP Domain # 2 Reimbursement
methodologies
1. 2nd step in reimbursement process
ANS Code assignment
2. 1st step in reimbursement process
ANS Documentation - medical/ financial record
3. 3rd step in reimbursement process
ANS Claim preparation
4. 4th step in reimbursement process
ANS Claim to payer(s)
5. 5th step in reimbursement process
ANS Claim review
6. 6th step in reimbursement process
ANS Claim resolution
7. What are the 2 types of outpatient coding situations
ANS 1. Coding for physicians
,2. Coding for facilities
8. What does medical biller use as foundation for determining who should
receive bills and who has responsibility for payment?
ANS Demographic information
9. When is demographic information collected
ANS Front office during pre-regristra- tion
10.CDM stands for
ANS Charge Description Master
11. List of all supplies, services, equipment, usage fees for patient care
ANS -
Charge Description Master
12.Coders perform the coding on procedures that vary from patient to pa-
tient.
ANS Soft Coding
13.Done by CDM. Automatically assigns codes based on a unique identifier
number of routine services
ANS Hard coding
14. - CPT/HCPCS procedure code
- Charge descripition
,- Revenue Code
- Charge
- Department code
- Charge Code
- Charge Status
ANS Charge Master Contents
15.Price established and assigned to a unit of medical/ other service in
facility
ANS Fee/ Charge
16.How often is Chargemaster updated
ANS Annually
17.What does chargemaster code by using the service identifier
ANS Routine services
18.Identifies procedure, service, product (incl. meds), other items provided to
patient
ANS Charge / item description
19.CPT/ HCPCS level II codes identify specific supplied to patient. Not all
have corresponding CPT/ HCPCS II codes.
ANS Procedure, service, product code
, 20.Unique 4-digit number that represents descriptions and dollar amounts
charges for hospital services provided to patient. Must accompany valid
procedure codes to be accepted
ANS Revenue code
methodologies
1. 2nd step in reimbursement process
ANS Code assignment
2. 1st step in reimbursement process
ANS Documentation - medical/ financial record
3. 3rd step in reimbursement process
ANS Claim preparation
4. 4th step in reimbursement process
ANS Claim to payer(s)
5. 5th step in reimbursement process
ANS Claim review
6. 6th step in reimbursement process
ANS Claim resolution
7. What are the 2 types of outpatient coding situations
ANS 1. Coding for physicians
,2. Coding for facilities
8. What does medical biller use as foundation for determining who should
receive bills and who has responsibility for payment?
ANS Demographic information
9. When is demographic information collected
ANS Front office during pre-regristra- tion
10.CDM stands for
ANS Charge Description Master
11. List of all supplies, services, equipment, usage fees for patient care
ANS -
Charge Description Master
12.Coders perform the coding on procedures that vary from patient to pa-
tient.
ANS Soft Coding
13.Done by CDM. Automatically assigns codes based on a unique identifier
number of routine services
ANS Hard coding
14. - CPT/HCPCS procedure code
- Charge descripition
,- Revenue Code
- Charge
- Department code
- Charge Code
- Charge Status
ANS Charge Master Contents
15.Price established and assigned to a unit of medical/ other service in
facility
ANS Fee/ Charge
16.How often is Chargemaster updated
ANS Annually
17.What does chargemaster code by using the service identifier
ANS Routine services
18.Identifies procedure, service, product (incl. meds), other items provided to
patient
ANS Charge / item description
19.CPT/ HCPCS level II codes identify specific supplied to patient. Not all
have corresponding CPT/ HCPCS II codes.
ANS Procedure, service, product code
, 20.Unique 4-digit number that represents descriptions and dollar amounts
charges for hospital services provided to patient. Must accompany valid
procedure codes to be accepted
ANS Revenue code
