QUESTION: 381

under Medicare Part B, all of the following statements are true and are applicable to nonparticipating physician providers, EXCEPT

providers must file all Medicare claims.
nonparticipating providers have a higher fee schedule than that for participating providers.
fees are restricted to charging no more than the "limiting charge" on nonassigned claims.
collections are restricted to only the deductible and coinsurance due at the time of service on an assigned claim.

Answer(s): B

Reveal Solution Next Question

QUESTION: 382

Under Medicare, a beneficiary has lifetime reserve days. All of the following statements are true, EXCEPT

the patient has a total of 60 lifetime reserve days.
lifetime reserve days are usually reserved for use during the patient's final terminal hospital stay.
lifetime reserve days are paid under Medicare Part B.
lifetime reserve days are not renewable, meaning once a patient uses all of their lifetime reserve days, the patient is responsible for the total charges.

Answer(s): C

Reveal Solution Next Question

QUESTION: 383

The term used to describe a diagram depicting grouper logic in assigning MS-DRGs is

blended chart.
case-mix index.
decision tree.
grouper hierarchy.

Answer(s): C

Reveal Solution Next Question

Once all data are posted to a patient's account, the claim can be reviewed for accuracy and completeness. Many facilities have internal auditing systems. The auditing systems run each claim through a set of edits specifically designed for the various third-party payers. The auditing system identifies data that have failed edits and flags the claim for correction. These "internal" auditing systems are called

scrubbers.
outliers.
groupers.
encoders.

Answer(s): A

Reveal Solution Next Question

Free RHIA Exam Braindumps (page: 96)

QUESTION: 381

QUESTION: 382

QUESTION: 383

QUESTION: 384