Domain 4 CDIP notes Part 1 of 6 exam questions with correct answers

Domain 4 CDIP notes Part 1 of 6 exam questions with correct answers Which contractor has more latitude when conducting reviews? - Answer-MACs Why are organizations typically more concerned about RACs? - Answer-They were responsible for reviewing improper payment claims, and there's a higher probability improper payments have been made What are improper payments the result of? - Answer-*Billing for Non-covered services *Billing for services not Med Nec * Incorrectly coded services *Duplicate services *Incorrect Payment amounts What validations did RACs historically conduct? - Answer-Coding, Med Ned and Clinical in both inpt and outpt. Who must RACs Employ? - Answer-Certified coders w/ atleast 5 yrs exp, they perform the coding reviews and DRG validations. RN's are employed for Med Nec and Clinical Validations. that was then Who's responsible for Med Nec Reviews now? - Answer-Quality Improvement Organization, validation of patient status and the correct assignment of such. Why is correct assignment of patient status necessary? - Answer-For payment to be accurate since the reimbursement methodologies are different for Medicare Parts