Nurs 8024 Pharmacology Exam 2 (Latest Update)
Review-Writer-Avatar: Q’s And A’s
What are collection agency fees based on? Right Ans - A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Right Ans - Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? Right Ans - Case rates What customer service improvements might improve the patient accounts department? Right Ans - Holding staff accountable for customer service during performance reviews What is an ABN (Advance Beneficiary Notice of Non-coverage) required to do?Right 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? Right Ans - Bad debt adjustment What is the initial hospice benefit? Right Ans - Two 90-day periods and an unlimited number of subsequent periods When does a hospital add ambulance charges to the Medicare inpatient claim?Right 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? Right Ans - Post a late-charge adjustment to the account an increase in the dollars aged greater than 90 days from date of service indicate what about accounts Right Ans - They are not being processed in a timely manner 1 / 2
What is an advantage of a preregistration program? Right Ans - It reduces processing times at the time of service What are the two statutory exclusions from hospice coverage? Right Ans - Medically unnecessary services and custodial care What core financial activities are resolved within patient access? Right Ans
- Scheduling, insurance verification, discharge processing, and payment of
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point-of-service receipts What statement applies to the scheduled outpatient? Right Ans - The services do not involve an overnight stay How is a mis-posted contractual allowance resolved? Right Ans - Comparing the contract reimbursement rates with the contract on the admittance advice to identify the correct amount What type of patient status is used to evaluate the patient's need for inpatient care? Right Ans - Observation Coverage rules for Medicare beneficiaries receiving skilled nursing care require that the beneficiary has received what? Right Ans - Medically necessary inpatient hospital services for at least 3 consecutive days before the skilled nursing care admission When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?Right Ans - When the patient is the insured What are non-emergency patients who come for service without prior notification to the provider called? Right Ans - Unscheduled patients If the insurance verification response reports that a subscriber has a single policy, what is the status of the subscriber's spouse? Right Ans - Neither enrolled not entitled to benefits Regulation Z of the Consumer Credit Protection Act, also known as the Truth in Lending Act, establishes what? Right Ans - Disclosure rules for consumer credit sales and consumer loans