Free RHIA Exam Braindumps (page: 100)

To monitor timely claims processing in a hospital, a summary report of "patient receivables" is generated frequently. Aged receivables can negatively affect a facility's cash flow; therefore, to maintain the facility's fiscal integrity, the HIM manager must routinely analyze this report.

Assume the patient has already met his or her deductible and that the physician is a nonparticipating Medicare provider, but does accept assignment. The standard fee for the services provided is $120.00. Medicare's PAR fee is $60.00 and Medicare's nonPAR fee is $57.00. How much reimbursement will the physician receives from Medicare?

The occurrence of an OCE (outpatient code editor) edit can result in one of __________ different dispositions, which help to ensure that the fiscal intermediaries in all parts of the country are following similar claims processing procedures. An example of one of these dispositions is "claim rejection."

All of the following statements are true of MS-DRGs, EXCEPT