Exam 2 Notes Nur 221 Latest Update 2024-2025 Already Graded A+

Exam 2 Notes Nur 221 Latest Update 2024-2025 Already
Graded A+
What activities are completed when a scheduled pre-registered patient
arrives for service? Exam 2 Notes Nur 221 Latest Update 2024-2025 Already
Graded A+
What activities are completed when a scheduled pre-registered patient
arrives for service? - ANS-Registering the patient and directing the
patient to the service area
In addition to being supported by information found in the patient's chart,
a CMS 1500 claim must be coded using what? - ANS-HCPCS
(Healthcare Common Procedure Coding system)
What results from a denied claim? - ANS-The provider incurs rework and
appeal costs
Why does the financial counselor need pricing for services? - ANS-To
calculate the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form -
ANS-Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - ANS-Appeal
conditions specified in the individual payer's contract
The important message from Medicare provides beneficiaries with
information concerning what? - ANS-Right to appeal a discharge
decision if the patient disagrees with the services
Why do managed care plans have agreements with hospitals,
physicians, and other healthcare providers to offer a range of services to
plan members? - ANS-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for
more than 30 days, what is the SNF permitted to do? - ANS-Submit
interim bills to the Medicare program.
What are collection agency fees based on? - ANS-A percentage of
dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ANS-Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - ANS-Case
rates
What customer service improvements might improve the patient
accounts department? - ANS-Holding staff accountable for customer
service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required
to do? - ANS-Inform a Medicare beneficiary that Medicare may not pay
for the order or service
What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance? - ANS-Bad debt adjustment
What is the initial hospice benefit? - ANS-Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? - ANS-If the patient requires ambulance transportation to a
skilled nursing facility
How should a provider resolve a late-charge credit posted after an
account is billed? - ANS-Post a late-charge adjustment to the account
- ANS-Registering the patient and directing the
patient to the service area
In addition to being supported by information found in the patient's chart,
a CMS 1500 claim must be coded using what? - ANS-HCPCS
(Healthcare Common Procedure Coding system)
What results from a denied claim? - ANS-The provider incurs rework and
appeal costs
Why does the financial counselor need pricing for services? - ANS-To
calculate the patient's financial responsibility
What type of provider bills third-party payers using CMS 1500 form -
ANS-Hospital-based mammography centers
How are disputes with nongovernmental payers resolved? - ANS-Appeal
conditions specified in the individual payer's contract
The important message from Medicare provides beneficiaries with
information concerning what? - ANS-Right to appeal a discharge
decision if the patient disagrees with the services
Why do managed care plans have agreements with hospitals,
physicians, and other healthcare providers to offer a range of services to
plan members? - ANS-To improve access to quality healthcare
If a patient remains an inpatient of an SNF (skilled nursing facility for
more than 30 days, what is the SNF permitted to do? - ANS-Submit
interim bills to the Medicare program.
What are collection agency fees based on? - ANS-A percentage of
dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? - ANS-Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? - ANS-Case
rates
What customer service improvements might improve the patient
accounts department? - ANS-Holding staff accountable for customer
service during performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required
to do? - ANS-Inform a Medicare beneficiary that Medicare may not pay
for the order or service
What type of account adjustment results from the patient's
unwillingness to pay for a self-pay balance? - ANS-Bad debt adjustment
What is the initial hospice benefit? - ANS-Two 90-day periods and an
unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? - ANS-If the patient requires ambulance transportation to a
skilled nursing facility
How should a provider resolve a late-charge credit posted after an
account is billed? - ANS-Post a late-charge adjustment to the account