AAHAM Full Exam

AAHAM Full Exam A hospital inpatient admit through discharge claim would be what Type of Bill (TOB) on the UB-04? - 111 True/False Average Daily Census is the average number of inpatients maintained in the hospital each day for a specific period of time. - True Which type of claim requires HCPCS/CPT codes? - Outpatient Claims Which of the following is not true of a CAH? -They must maintain no more than 25 inpatient beds that may be used for swing bed services -They may operate a rehabilitation/psychiatric DPU, each with up to 10 beds -They can have an ALOS of 72 hours of less per patient for acute care (excluding swing bed and beds within DPUs) -They must furnish 24/7 emergency care services - They can have an ALOS of 72 hours of less per patient for acute care (excluding swing bed and beds within DPUs) What is the name of the Medicare rule that all diagnostic and clinically related non-diagnostic outpatient services provided within a certain number of days of an inpatient admission must be combined to the inpatient claim when provided by an entity wholly owned or operated by the inpatient hospital? - 3-Day Payment Window Rule The Fair Debt Collection Practices Act (FDCPA) prohibits: - -Harassment or abuse in the collection process -Use of false or misleading information in the collection process -Contacting the consumer before 8:00 a.m. or after 9:00 p.m. HHS - Department of Health and Human Services What are valid conditions preventing a consent form to be completed by the patient? - - Intoxicated -Unconscious -Declared mentally incompetent by the courts Which of the following is not gathered during preregistration or preadmission? -History of chief complaint -Patient demographics -Financial information -Socioeconomic information - History of chief complaint NCDs and LCDs - NCDs are medical review policies issued by CMS to identify specific items, services, procedures or technologies that can be covered and paid for by Medicare. LCDs are policies developed by MACs that specify criteria for services and show under what clinical circumstances an item or service is considered to be reasonable, necessary and appropriate Which of the following is an operating division of HHS? (Select all that apply) -Food and Drug Administration (FDA) -Department of Veterans Affairs (VA) -Administration for Community Living (ACL) -Administration for Children and Families (ACF) -Administration for Health Living for Seniors (AHLS) - -Food and Drug Administration (FDA) -Administration for Community Living (ACL) -Administration for Children and Families (ACF What is the consequence when timely-filing limits are not met when a claim is billed? - The claim is written off, as billing the patient is not allowed Which of the following is not true of coordination of benefits? -Group health plans are always secondary to Medicare -Medicaid is always the payer of last resort except for Indian Health Service -TRICARE is also the payer of last resort except for Medicaid, TRICARE supplements, the Indian Health Service and other programs or plans as identified by the TRICARE Management Activity -Almost all payers are secondary to any liability or