Which of the following is a common registration error that will affect the revenue cycle? Transposed digits in the social security number, date of birth, or policy number In a typical acute-care setting, charge capture is located in which revenue cycle area? Claims processing Which of the following establish eligibility standards for enrollment in Medicaid? Individual states This program provides additional federal funds to states so that Medicaid eligibility can be expanded to include a greater number of children. SCHIP The charge description master relieves the HIM department of ___ that does not require documentation analysis Repetitive coding After a claim has been filed with Medicare, a healthcare organization had late charges posted to a patient's outpatient account that changed the calculation of the APC. What is the best practice for this organization to receive the correct reimbursement from Medicare? Submit an adjusted claim to Medicare Which term refers to the electronic transmission of information from a provider to a health plan to determine a patient's eligibility for services? Coordination of benefits transaction Which of the following agencies is responsible for providing healthcare services to American Indians and Alaska natives? IHS Which of the following insurance covers healthcare costs and lost income associated with work-related injuries? Workers' Compensation A Medicare benefit period is defined as: Beginning the day the Medicare patient is admitted to the hospital and ending when the patient has been out of the hospital for 60 days in a row, including the day of discharge The patient's account balance is displaying a negative balance. What should the health care organization do to resolve this situation? Determine which payer overpaid and return the funds The unique number that identifies each service or supply in the CDM and links each item to a particular department is known as the: Charge code All of the following are required elements of a charge description master except: Date of service The codes used in a charge description master are: HCPCS Levels I and II The codes used in a charge description master are: HCPCS Levels I and II The facility's Medicare case-mix index has dropped, although other statistical measures appear constant. The CFO suspects coding errors. What type of coding quality review should be performed? Focused audit
The most recent coding audit has revealed a tendency to miss secondary diagnoses that would have increased reimbursement for the case. Which of the following strategies will help to identify and correct these cases in the short term? Focused reviews on lower weighted MS-DRGs from triples and pairs There should be four primary percentages that should be calculated and tracked to assess clinical documentation improvement (CDI) programs. These include all of the following except: Record agreement rate CDI staff should revisit cases: Every 24 to 48 hours The federal legislation that focused on healthcare fraud and abuse issues, especially as they relate to penalties, was the: Balanced Budget Act of 1997 Which of the following services would be included in the 72-hour payment window and included in the inpatient MS-DRG payment to an acute-care hospital? Diagnostic laboratory testing
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