Medicare reimbursement Study guides, Class notes & Summaries

LA Life, Health & Accident Insurance Series 103 Practice Exam Questions and Answers Already Passed Under which situation must insurable interest exist between the applicant and insured at the time of application? When a third-party applicant names themselves beneficiary. Which of the following is true about a decreasing term life policy? The face amount reaches zero at policy expiration. Which of the following occurs immediately after the application is submitted and the initial premium paid?...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided ...

1. Florence Nightingales contributions to nursing practice and education: a. Are historically important but have no validity for nursing today. b. Were neither recognized nor appreciated in her own time. c. Were a major factor in reducing the death rate in the Crimean War. d. Were limited only to the care of severe traumatic wounds. ANS: C By improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingales nurses dramatically reduced the death rate from injuri...

TEST BANK FOR MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 3TH EDITION DEWIT-1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defi...

CDIP Practice Exam Questions With Complete Solutions | Latest 2023/2024 Graded A+. During an outpatient procedure for removal of a bladder cyst, the urologist accidentally tore the urethral sphincter requiring an observation stay. This should be assigned as the principal diagnosis: a.The reason for the outpatient surgery b.The reason for admission c.Either the reason for the outpatient surgery or the reason for admission d.None of the above - Answer- a When a patient presents for outpatien...

Chapter 01: Food, Nutrition, and Health Nix: Williams' Basic Nutrition and Diet Therapy, 16th Edition MULTIPLE CHOICE 1. Promoting a health care service that improves diabetes management for the elderly in a community would assist in which of the following? a. Supporting the national health goals Healthy People 2020 b. Reducing hunger in a subset of the United States population c. Improving Medicare reimbursement claims d. Providing access to primary health care services ANS: A ...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo & Robinson Test Bank UNIT I. THE FOUNDATION Chapter 1. The Role of the Nurse Practitioner as Prescriber Chapter 2. Review of the Basic Principles of Pharmacology Chapter 3. Rational Drug Selection Chapter 4. Legal and Professional Issues in Prescribing Chapter 5. Adverse Drug Reactions Chapter 6. An Introduction to Pharmacogenetics Chapter 7. Nutrition and Neutraceuticals Chapter 8. Herbal Therapies and Can...

How long after being entitled to disability benefits will an individual be eligible to receive Medicare benefits? A. immediately B. 1 year C. 2 years D. At age 65 - ANSWER-2 years What is the return of premium rider? A. an increasing amount of term insurance that always equals the total of premiums paid up to the current point B. a provision that allows the insured to cancel the policy in the first two years and have premiums refunded C. an increasing amount of term insurance that e...