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Which of the following is the definition of revenue cycle management? |
Coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue |
What is the name of the notice sent after the provider files a claim that details amounts billed by the provider, amounts approved by the payer, how much the payer paid, and what the patient must pay? |
EOB |
In a typical acute-care setting, admitting is located in which revenue cycle area? |
Pre-claims submission |
In healthcare settings, the record of the cash the facility will receive for the service it has provided is known as which of the following terms? |
Accounts receivable |
The amount of money owed a healthcare facility when claims are pending is called? |
Dollars in accounts receivable |
The remittance advice is provided to which party? |
Facility |
In a typical acute-care setting, aging of accounts reports are monitored in which revenue cycle area? |
Accounts receivable |
In regard to accounts receivable management, the older the account or the longer the account remains unpaid the less of a chance that the facility will receive reimbursement for the encounter. |
True |
The difference between what is charged and what is paid is known as? |
Contractual allowance |
The term "soft coding" refers to? |
CPT codes that are coded by the coder |
Which is a characteristic of the "old" RCM approach?
Silo mentality
When revenue cycle analysts examine MS-DRG relationships reporting they examine MS-DRG families for differences in_________ reporting?
Complication/comorbidity
In a typical acute-care setting, patient education of payment policies is located in which revenue cycle area?
Pre-claims submission
Which of the following is not a benefit of an integrated revenue cycle?
Separation of physician practices
In a typical acute-care setting, the explanation of benefits, Medicare summary notice, and remittance advice documents (provided by the payer) are monitored in which revenue cycle area?
Claims reconciliation/collections
Which type of compliance guidance is used by Medicare to communicate policies and procedures for the specific prospective payment systems manuals?
Medicare Claims Processing Manual
Which entity is responsible for processing Part A claims and hospital-based Part B claims for institutional services on behalf of Medicare?
Medicare Administrative Contractor
Which type of compliance is used by Medicare to describe the circumstances under which specific medical supplies, services or procedures are covered nationwide by Medicare?
National Coverage Determinations
Which of the following is not a use of the CDM?
Coder productivity
Which of the following is not a function area of the revenue cycle?
Cafeteria
The dollar amount the facility actually bills for the services it provides is known as?
Charge
Which of the following CDM data element is nationally recognized?
Revenue code
In a typical acute-care setting, charge entry is located in which revenue cycle area?
Claims processing
Which of the following is not used to reconcile accounts in the patient accounting department?
Medicare code editor
In a typical acute-care setting, which revenue cycle area uses an internal auditing system (scrubber) to ensure that error free claims (clean claims) are submitted to third-party payers?
Claims processing
Scrubbers are used by hospitals to identify which of the following errors that can cause claims rejection or denials?
All of the above
All of the following elements are found in a charge description master, except?
ICD-10-CM code
Most facilities begin counting days in accounts receivable at which of the following times?
The date the bill drops
Which of the following compliance documents services as day-to-day operating instructions for administering CMS programs?
CMS program transmittals
There are nationally recognized rules regarding the use of charge descriptions for CPT codes in the CDM?
False
Principles of Healthcare Reimbursement:Instructor’s ManualChapter 96.True or false? In regard to accounts receivable management, the older the account orthe longer the account remains unpaid, the less of a change that the facility willreceive reimbursement for the encounter.
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7.Most facilities begin counting days in accounts receivable at which of the followingtimes?
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8.The amount of money owed a healthcare facility when claims are pending is called:
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9.The dollar amount the facility actually bills for the services it provides is known as:a. Costb. Chargec. Reimbursementd. Contractual allowance
10. The difference between what is charged and what is paid is known as:
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11. What is the name of the notice sent after the provider files a claim that detailsamounts billed by the provider, amounts approved by the payer, how much the payerpaid, and what the patient must pay?
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Looking for Expert Opinion?
Let us have a look at your work and suggest how to improve it!
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Which of the following is the definition of revenue cycle management? |
Coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue |
What is the name of the notice sent after the provider files a claim that details amounts billed by the provider, amounts approved by the payer, how much the payer paid, and what the patient must pay? |
EOB |
In a typical acute-care setting, admitting is located in which revenue cycle area? |
Pre-claims submission |
In healthcare settings, the record of the cash the facility will receive for the service it has provided is known as which of the following terms? |
Accounts receivable |
The amount of money owed a healthcare facility when claims are pending is called? |
Dollars in accounts receivable |
The remittance advice is provided to which party? |
Facility |
In a typical acute-care setting, aging of accounts reports are monitored in which revenue cycle area? |
Accounts receivable |
In regard to accounts receivable management, the older the account or the longer the account remains unpaid the less of a chance that the facility will receive reimbursement for the encounter. |
True |
The difference between what is charged and what is paid is known as? |
Contractual allowance |
The term "soft coding" refers to? |
CPT codes that are coded by the coder |
Which is a characteristic of the "old" RCM approach? |
Silo mentality |
When revenue cycle analysts examine MS-DRG relationships reporting they examine MS-DRG families for differences in_________ reporting? |
Complication/comorbidity |
In a typical acute-care setting, patient education of payment policies is located in which revenue cycle area? |
Pre-claims submission |
Which of the following is not a benefit of an integrated revenue cycle? |
Separation of physician practices |
In a typical acute-care setting, the explanation of benefits, Medicare summary notice, and remittance advice documents (provided by the payer) are monitored in which revenue cycle area? |
Claims reconciliation/collections |
Which type of compliance guidance is used by Medicare to communicate policies and procedures for the specific prospective payment systems manuals? |
Medicare Claims Processing Manual |
Which entity is responsible for processing Part A claims and hospital-based Part B claims for institutional services on behalf of Medicare? |
Medicare Administrative Contractor |
Which type of compliance is used by Medicare to describe the circumstances under which specific medical supplies, services or procedures are covered nationwide by Medicare? |
National Coverage Determinations |
Which of the following is not a use of the CDM? |
Coder productivity |
Which of the following is not a function area of the revenue cycle? |
Cafeteria |
The dollar amount the facility actually bills for the services it provides is known as? |
Charge |
Which of the following CDM data element is nationally recognized? |
Revenue code |
In a typical acute-care setting, charge entry is located in which revenue cycle area? |
Claims processing |
Which of the following is not used to reconcile accounts in the patient accounting department? |
Medicare code editor |
In a typical acute-care setting, which revenue cycle area uses an internal auditing system (scrubber) to ensure that error free claims (clean claims) are submitted to third-party payers? |
Claims processing |
Scrubbers are used by hospitals to identify which of the following errors that can cause claims rejection or denials? |
All of the above |
All of the following elements are found in a charge description master, except? |
ICD-10-CM code |
Most facilities begin counting days in accounts receivable at which of the following times? |
The date the bill drops |
Which of the following compliance documents services as day-to-day operating instructions for administering CMS programs? |
CMS program transmittals |
There are nationally recognized rules regarding the use of charge descriptions for CPT codes in the CDM? |
False |