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