TeeGrades

What is the CMS-adopted NFPA standard for portable fire extinguishers? - NFPA 10 2010 Edition What is the CMS-adopted NFPA National Electric Code? - NFPA 70 2011 Edition What is the CMS-adopted NFPA standard for a health care facilities code? - NFPA 99 2012 Edition What is the title of CMS-adopted NFPA 241? - Standard for Safeguarding Construction, Alteration and Demolition Operations 2009 Edition Where can you find design standards adopted by the majority of...

reporting all events (marketing/sales and educational) to united health care is required so that the company can: - Comply with CMS and medicaid services event reporting You have a scheduled appointment with a consumer to discuss DSNP. They have the SOA form. 2 days before the appointment they call and request to discuss PDP, which you are certified to sell. What do you tell them? - tell the consumer to sign a new SOA before the appointment which election period occurs october 15 to ...

Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1. An agent is explaining Medicare Advantage plan options to a consumer. During the conversation, the agent explains that Medicare gives each plan...

What type of events must an agent report to UnitedHealthcare? - Only the marketing/sales events, both formal and informal. While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Leave any field requesting a consumer email address blank. Which election period occurs from October 15 to December 7? - Annual Election Period (AEP) Which of the following materials is an agent NOT pe...

Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1. Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? - Mrs. Violet...

What is a servicing agent? - an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare basics and ethics compliance assessments on an annual basis What does CMS stand for? - center for medicare and medicaid services Who administers the medicare program and contracts with priva...

In terms of events, which of the following is true? - WRONG - Agents must report formal marketing/sales events only to UnitedHealthcare When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's email address? - The consumer/member would not receive plan related correspondence intended for him/her. Annual Election Period (AEP) is a time when: - Consumers can elect to join a Medicare A...

Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? - ******* When completing an enrollment application in LEAN, why is an agent prohibited from entering his or ...

The nurse is caring for a patient admitted with hypovolemic shock. The nurse palpates thready brachial pulses but is unable to auscultate a blood pressure. What is the best nursing action? a. Assess the blood pressure by Doppler. b. Estimate the systolic pressure as 60 mm Hg. c. Obtain an electronic blood pressure monitor. d. Record the blood pressure as not assessable. A ~ Auscultated blood pressures in shock may be significantly inaccurate due to vasoconstriction. If blood pressure is not...

COC 2022-23 - Final Exam Questions and Answers Test Bundle

WRA Exam Questions with 100% Correct Solutions Test Bundle

Destruction of lesions of the vulva can be done with "cryosurgery". This method uses: - Extreme cold Differences between coding surgical and diagnostic procedures for the outpatient facility and the provider: - Answer: Modifiers and payment methodology are different for the outpatient facility and the provider Response Feedback: Rationale: In most cases, the codes selected for surgical procedures and diagnostic procedures are the same whether you are coding for the outpatient facility...

After suffering a fracture of the ankle three months ago, a 69 year-old patient presented with what was found to be a malunion fracture. She was treated with additional surgery and discharged. Which injury diagnosis code(s) is/are assigned? - S82.899P All codes in ICD-10-PCS have how many characters? - 7 All entries in the medical record must be: - Signed and dated by the author with a method to establish the author's identity. All payers employ the same rules concerning codin...

The CoC does special studies Every calendar year Every two years Periodically When requested by a member of the American College of Surgeons - Periodically Standard 5.7 states that the CoC periodically designs and conducts hypothesis-based special studies to evaluate patient care, set performance benchmarks, and provide feedback to improve cancer patient care_ the ____ accreditation program is for ______ ________ and independent cancer centers and is the result of a cooperative ef...

Which service is reimbursed based on the APC payment method? - Patient X-ray of left foot in the outpatient department Rationale: The APC system is a payment methodology for outpatient, or ambulatory, facility services. It does not include the professional component of ambulatory care, which is paid under the Resource-Based Relative Value Scale (RBRVS) methodology. Also it does not include services and procedures that require inpatient care and/or procedures paid under an existing fee schedul...

Debridement is best described as: A. Removal of scabbed tissue resulting from burns B. Removal of dead or damaged tissue as from a wound C. Transplantation of human skin D. A plastic surgical procedure for removing scars or birthmarks by chemical or mechanical distraction of epidermal tissue - B What is an abscess? A. Necrotized skin resulting from a burn B. Lesion on the surface of the skin that penetrates the epidermal is caused by superficial loss of tissue C. Cavity created by l...

Packaged services can be reported and paid separately under OPPS? - False OPPS was implemented to: - Create a PPS for outpatient facility services Packaged services include: - Recovery room, routine supplies, drugs considered integral part of procedure, anesthesia What status indicated is applied to an inpatient service not paid under OPPS? - C The purpose of OPPS is to: - Control hospital reimbursement for outpatient services To qualify for an outlier payment for o...

In most hospitals, coding is performed in: a. Provider-based clinics b. HIM department c. Ancillary clinical departments d. All of the above - All of the above Rationale: In most hospitals, coding is performed in several areas including: Provider-based clinics, Health Information Management Department, and Ancillary clinical departments. A plan of care submitted by the provider to the case manager when seeking certification is called: - Treatment plan Rationale: Treatment pl...

What is the purpose of the Operation Restore Trust program? - An effort to restore integrity in the Medicare program and to find and stop fraud and waste in the Medicare and Medicaid programs. What is the reported HCPCS code for a diaphragm for contraceptive use? - A4266 What is the reported HCPCS code for a Levine type stomach tube? - B4083 What is the reported HCPCS code for Mitomycin, 40 mg, given intravenously? - J9280 x 8 What is the reported HCPCS code for two leg s...

When changes to the CDM results in an increase in revenue, which group should review the impact of these changes to revenue? - Answer: The Compliance Committee. A statement is sent to the patient as soon as: - Answer: Payments are posted and denials are resolved. Rationale: After the business office receives an explanation of benefits (EOB), the claim payment and contractual adjustments are posted and then a statement is mailed to the patient for the amount determined to be patient res...