QUESTION: 13

Concurrent review states that:

Planning appropriateness and medical necessity of a hospital stay while the patient is in the hospital and implementing discharge planning.
Monitoring appropriateness and medical necessity of a hospital stay while the patient is not in the hospital and try to implement discharge planning.
Planning appropriateness and medical necessity of a hospital stay while the patient is not in the hospital and try to implement preadmission planning.
Monitoring appropriateness and medical necessity of a hospital stay while the patient is in the hospital and implementing discharge planning.

Answer(s): D

QUESTION: 14

Gatekeepers requiring a patient to obtain a referral from his or her primary care physician, the gatekeeper, before assign a specialist.

True
False

Answer(s): A

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QUESTION: 15

Requiring providers to have their capital expenditures preapproved by an independent state agency to avoid unnecessary duplication of services is referred to as:

Preapproval certifications and opinions
Preapproved payments
Certificate of need
State service reviews

Answer(s): C

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QUESTION: 16

Which one of the following systems is used to classify inpatients based o their diagnoses, used by both Medicare and private insurers?

Diagnosis-related groups
Proactive payments system
Payment insurance group
None of the above

Answer(s): A

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QUESTION: 13

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QUESTION: 16

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