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NR 599 /NR 599 Midterm Exam ..Nursing Informatics for Advanced Practice NR 511 WEEK 1 :QUIZ 1 The phrase usual and customary refersto: The success rate of a specified procedure. How much an insurer will charge to provide coverage. Correct Answer How charg

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NR 599 /NR 599 Midterm Exam ..Nursing Informatics for Advanced Practice NR 511 WNR 599 /NR 599 Midterm Exam ..Nursing Informatics for Advanced Practice NR 511 WEEK 1 :QUIZ 1 The phrase usual and customary refersto: The success rate of a specified procedure. How much an insurer will charge to provide coverage. Correct Answer How charges for a service compares with charges made to other personsreceiving similar services and supplies. How an insurer evaluatesthe need for an ordered diagnostic test. The phrase usual and customary refers to the comparison of charges with other like chargesfor services and supplies received in the immediate vicinity as well as in a broader geographic area. What must you do as an advanced practice registered nurse (APRN) before billing for visits? Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer. Provide evidence of continuing medical education Obtain a Drug Enforcement Administration (DEA) number. Establish a collaborative agreement with a physician. To bill your clientsforservices, you must obtain a provider number and familiarize yourself with the rules and policies of each payor. Which one of the following is true regarding the importance of documentation? It allows you to communicate your findings to other providers and serves as a record for the visit. It is only important in order to bill the patient for your service. It is only important for defending yourself in the event of a law suit. It allows you to communicate your findings with the general public. Question 4 1 / 1 pts Question 5 1 / 1 pts Question 6 1 / 1 pts The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family factors, positive and negative findings on physical exam and the provider's plan. Documentation is important for billing purposes, communication with other providers and in the case litigation. Which of the following statements does not belong in the past medical history portion of your chart note? Correct Answer Your patient had lab work done at their last appointment; CBC was normal. Your patient’s father passed away from lung cancer. Your patient had a cholecystectomy 3 years prior. Your patient has an allergy to penicillin. Allergies, family history and surgical history all belong in the history portion of your note. Test results are objective findings and should be in the diagnostic tests (objective) section of the note. In relation to writing a patient encounter note, the acronym SOAP standsfor which of the following? Subjective, objective, assessment, plan. Symptoms, observations, assessment, plan. Symptoms, objective findings, assessment, plan. Subjective, outward findings, assessment, plan. The acronym SOAP stands for subjective, objective, assessment and plan. Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does this mean? The HMO reimbursesthe provider on a fee-for-service basis. The HMO is not responsible for provider reimbursement. The HMO reimburses the provider only if the patient has paid their deductible. Correct Answer The HMO reimburses the provider a predetermined fee per client per month based on the client’s age and sex. The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid, comprehensive systems of health benefits that combine both financing and delivery of services to subscribers. They may pay providers on a capitated or fee-for-service basisEEK 1 :QUIZ 1 The phrase usual and customary refersto: The success rate of a specified procedure. How much an insurer will charge to provide coverage. Correct Answer How charges for a service compares with charges made to other personsreceiving similar services and supplies. How an insurer evaluatesthe need for an ordered diagnostic test. The phrase usual and customary refers to the comparison of charges with other like chargesfor services and supplies received in the immediate vicinity as well as in a broader geographic area. What must you do as an advanced practice registered nurse (APRN) before billing for visits? Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer. Provide evidence of continuing medical education Obtain a Drug Enforcement Administration (DEA) number. Establish a collaborative agreement with a physician. To bill your clientsforservices, you must obtain a provider number and familiarize yourself with the rules and policies of each payor. Which one of the following is true regarding the importance of documentation? It allows you to communicate your findings to other providers and serves as a record for the visit. It is only important in order to bill the patient for your service. It is only important for defending yourself in the event of a law suit. It allows you to communicate your findings with the general public. Question 4 1 / 1 pts Question 5 1 / 1 pts Question 6 1 / 1 pts The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family factors, positive and negative findings on physical exam and the provider's plan. Documentation is important for billing purposes, communication with other providers and in the case litigation. Which of the following statements does not belong in the past medical history portion of your chart note? Correct Answer Your patient had lab work done at their last appointment; CBC was normal. Your patient’s father passed away from lung cancer. Your patient had a cholecystectomy 3 years prior. Your patient has an allergy to penicillin. Allergies, family history and surgical history all belong in the history portion of your note. Test results are objective findings and should be in the diagnostic tests (objective) section of the note. In relation to writing a patient encounter note, the acronym SOAP standsfor which of the following? Subjective, objective, assessment, plan. Symptoms, observations, assessment, plan. Symptoms, objective findings, assessment, plan. Subjective, outward findings, assessment, plan. The acronym SOAP stands for subjective, objective, assessment and plan. Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does this mean? The HMO reimbursesthe provider on a fee-for-service basis. The HMO is not responsible for provider reimbursement. The HMO reimburses the provider only if the patient has paid their deductible. Correct Answer The HMO reimburses the provider a predetermined fee per client per month based on the client’s age and sex. The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid, comprehensive systems of health benefits that combine both financing and delivery of services to subscribers. They may pay providers on a capitated or fee-for-service basis

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