Third party payer Study guides, Class notes & Summaries
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023
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CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 
Steps used to control costs of managed care include: 
Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
 
 
 
DRG is used to classify 
Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred 
 
 
 
Identify the various types of private health plan coverage 
HMO 
Conventional 
PPO and POS 
H...
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Test Bank: Olds’ Maternal-Newborn Nursing & Women’s Health Across the Lifespan, 11th Edition, Michele Davidson, Marcia London, Patricia Ladewig | Complete Guide 2022/23
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Olds Maternal-Newborn Nursing & Women’s Health Across the Lifespan 11th Edition Test Bank Instant delivery Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig) Chapter 1 Contemporary Maternal-Newborn Nursing 1) The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn...
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HFMA CRCR exam 2023 with 100% correct answers
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Through what document does a hospital establish compliance standards? 
code of conduct 
 
 
 
What is the purpose OIG work plant? 
Identify Acceptable compliance programs in various provider setting 
 
 
 
If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? 
Non-diagnostic service provided on Tuesday through Friday 
 
 
 
What does a modifier allow a provider to do? 
Report a specific circumstance that affected a procedure or service without chan...
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CHAA STUDY GUIDE| 268 QUESTIONS| WITH COMPLETE SOLUTIONS
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Master Study Guide I 
 
Pre-Encounter 
 
Customer Service impressions are formed by the staff's ATTITUDE (state of mind) and BEHAVIOR (action/reaction) towards them. correct answer: 1.ATTITUDE / BEHAVIOR 
 
_____________ may be any patient, family member, visitor, physician, other hospital personnel, third party payer, vendors, suppliers, etc. correct answer: 2.CUSTOMERS 
 
Internal customers are people in other____________, fellow ___________, management, information services, etc. within th...
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Test Bank: Olds’ Maternal-Newborn Nursing & Women’s Health Across the Lifespan, 11th Edition, Michele Davidson, Marcia London, Patricia Ladewig | Complete Guide 2022/23
- Exam (elaborations) • 783 pages • 2022
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Olds Maternal-Newborn Nursing & Women’s Health Across the Lifespan 11th Edition Test Bank Instant delivery Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig) Chapter 1 Contemporary Maternal-Newborn Nursing 1) The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn...
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Test Bank: Olds’ Maternal-Newborn Nursing & Women’s Health Across the Lifespan, 11th Edition, Michele Davidson, Marcia London, Patricia Ladewig | Complete Guide 2022/23
- Exam (elaborations) • 783 pages • 2022
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Olds Maternal-Newborn Nursing & Women’s Health Across the Lifespan 11th Edition Test Bank Instant delivery Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig) Chapter 1 Contemporary Maternal-Newborn Nursing 1) The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn...
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CSPR - Certified Specialist Payment Rep (HFMA) Exam 2023 with Complete Solutions
- Exam (elaborations) • 18 pages • 2023
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Steps used to control costs of managed care include: - ANSWER-Bundled codes 
Capitation 
Payer and Provider to agree on reasonable payment 
 
DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred 
 
Identify the various types of private health plan coverage - ANSWER-HMO 
Conventional 
PPO and POS 
HDHP/SO plans - high-deductible health plans with a savings...
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NHA CEHRS Final practice test review | 230 Questions with 100% Correct Answers | Updated & Verified
- Exam (elaborations) • 28 pages • 2022
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how does the registration process begin in an outpatient setting? - ANS - when a new patient 
calls the office for an appointment to see a provider. 
what does a front staff member do once they obtain information from a new patient? - ANS - 
they create an account that includes the patient's identity, medical condition, and 
insurance/payment info. 
what does a front staff member do once they obtain information from an established patient? - 
ANS - the staff member searches for the patient reco...
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MHA 610 Final Exam Questions & Answers 2023/2024
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MHA 610 Final Exam Questions & Answers 2023/2024 
 
 
"What is meant by the term "health care costs" Give the 3 meanings - ANSWER-1. Billings and premiums that the patient pays 
2.How much debt the nation is in for medical expenses 
3. The cost of producing services such as supplies and equipment 
 
Rand Health - How does it show relationship of rising costs and third party reimbursement? - ANSWER-The experiment showed how people who paid out of pocket were less likely to utilize the services...
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CRCR Exam Prep questions and answers 2023/2024
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CRCR Exam Prep 
What are collection agency fees based on? - correct answer A percentage of dollars collected 
 
Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - correct answer Birthday 
 
In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - correct answer Case rates 
 
What customer service improvements might improve the patient accounts department? - correct answer Ho...