If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window
rule? - answersDiagnostic and clinically-related non-diagnostic charges provided on the Tuesday,
Wednesday, Thursday, and Friday before admission
What is a benefit of pre-registering patient's for service? - answersPatient arrival processing is
expedited, reducing wait times and delays
What is a characteristic of a managed contracting methodology? - answersProspectively set rates for
inpatient and outpatient services
What do the MSP disability rules require? - answersThat the patient's spouse's employer must have
less than 20 employees in the group health plan
what organization originated the concept of insuring prepaid health care services? - answersBlue
Cross and blue Shield
What is true about screening a beneficiary for possible MSP situations? - answersIt is acceptable to
complete the screening form after the patient has completed the registration process and been sent
to the service department
If the patient cannot agree to payment arrangements, what is the next option? - answersWarn the
patient that unpaid accounts are placed with collection agencies for further processing
In services lines such as cardiology or orthopedics, what does the case-rate payment methodology
allow providers to do? - answersReceive a fixed for specific procedures
What will comprehensive patient access processing accomplish? - answersMinimize the need for
follow-up on insurance accounts
Through what document does a hospital establish compliance standards? - answersCode of conduct
How does utilization review staff use correct insurance information? - answersTo obtain approval for
inpatient days and coordinate services
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