Question 1

The majority of hospital reimbursement comes from:

Accepted Answer

A)  bank loans. 
B)  insurance companies. 
C)  patients. 
D)  private donations. 
A)  bank loans. 
B)  insurance companies. 
C)  patients. 
D)  private donations.

Question 2

Match the following
-Code used to identify the department or unit that rendered services

Accepted Answer

A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS) 
A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS)

Question 3

What does the process of admitting a patient to the hospital involve?

Accepted Answer

The process includes collectin

Question 4

The current federal reimbursement plan for outliers is to pay the full DRG rate plus an additional payment for services provided.

Accepted Answer

A) True 
 B)False

Question 5

The type of care that provides palliative services for terminally ill patients is known as:

Accepted Answer

A)  hospice care. 
B)  home healthcare. 
C)  critical care. 
D)  terminal care. 
A)  hospice care. 
B)  home healthcare. 
C)  critical care. 
D)  terminal care.

Question 6

Per diem is a type of reimbursement that pays a fixed rate per day for all services provided by a hospital.

Accepted Answer

A) True 
 B)False

Question 7

If the patient requires an operation, the physician who conducts the operation is referred to as the ________.

Accepted Answer

The answer of If the patient requires an operation, the...

Question 8

Match the following
-Code that establishes the level of urgency for admission

Accepted Answer

A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS) 
A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS)

Question 9

What is the Diagnosis Related Group (DRG) system?

Accepted Answer

The DRG system is a form of prospective

Question 10

Comorbidity may affect payment if the condition causes an increase in hospital length of stay by at least 2 days in approximately 50% of cases.

Accepted Answer

A) True 
 B)False

Question 11

What is the role of an attending physician?

Accepted Answer

An attending physici

Question 12

The UB-04 claim form is required by all private payers and is accepted by the Centers for Medicare and Medicaid Services (CMS).

Accepted Answer

A) True 
 B)False

Question 13

When referring to DRGs, the abbreviation CC is used to indicate:

Accepted Answer

A)  chief complaint. 
B)  closed case. 
C)  chronic condition. 
D)  complications or comorbidities. 
A)  chief complaint. 
B)  closed case. 
C)  chronic condition. 
D)  complications or comorbidities.

Question 14

What types of institutional facilities use the UB-04 claim form?

Accepted Answer

The UB-04 claim form is used to report s

Question 15

Software that is used to calculate the DRG payment group is called a(n):

Accepted Answer

A)  claims processing system. 
B)  grouper. 
C)  accounts receivable system. 
D)  database. 
A)  claims processing system. 
B)  grouper. 
C)  accounts receivable system. 
D)  database.

Question 16

The computerized comprehensive list of codes for all services and items provided to hospital patients is known as the ________.

Accepted Answer

charge des

Question 17

OPPS stands for:

Accepted Answer

A)  Outpatient Payment for Preventive Services. 
B)  Outpatient Prospective Payment System. 
C)  Optimal Payment for Procedures and Services. 
D)  Other Payments for Procedures and Services. 
A)  Outpatient Payment for Preventive Services. 
B)  Outpatient Prospective Payment System. 
C)  Optimal Payment for Procedures and Services. 
D)  Other Payments for Procedures and Services.

Question 18

What information is included in a charge description master (CDM)?

Accepted Answer

The information includes proce

Question 19

A code that describes an accident or mishap responsible for the patient's admission to the hospital is known as a(n):

Accepted Answer

A)  condition code. 
B)  occurrence code. 
C)  value code. 
D)  revenue code. 
A)  condition code. 
B)  occurrence code. 
C)  value code. 
D)  revenue code.

Question 20

The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is:

Accepted Answer

A)  capitation. 
B)  fee for service. 
C)  per diem. 
D)  prospective payment system. 
A)  capitation. 
B)  fee for service. 
C)  per diem. 
D)  prospective payment system.

The majority of hospital reimbursement comes from:

Match the following -Code used to identify the department or unit that rendered services

What does the process of admitting a patient to the hospital involve?

The current federal reimbursement plan for outliers is to pay the full DRG rate plus an additional payment for services provided.

The type of care that provides palliative services for terminally ill patients is known as:

Per diem is a type of reimbursement that pays a fixed rate per day for all services provided by a hospital.

If the patient requires an operation, the physician who conducts the operation is referred to as the ________.

Match the following -Code that establishes the level of urgency for admission

What is the Diagnosis Related Group (DRG) system?

Comorbidity may affect payment if the condition causes an increase in hospital length of stay by at least 2 days in approximately 50% of cases.

What is the role of an attending physician?

The UB-04 claim form is required by all private payers and is accepted by the Centers for Medicare and Medicaid Services (CMS).

When referring to DRGs, the abbreviation CC is used to indicate:

What types of institutional facilities use the UB-04 claim form?

Software that is used to calculate the DRG payment group is called a(n):

The computerized comprehensive list of codes for all services and items provided to hospital patients is known as the ________.

OPPS stands for:

What information is included in a charge description master (CDM)?

A code that describes an accident or mishap responsible for the patient's admission to the hospital is known as a(n):

The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 11: Hospital Medical Billing

The majority of hospital reimbursement comes from:

Match the following -Code used to identify the department or unit that rendered services

What does the process of admitting a patient to the hospital involve?

The current federal reimbursement plan for outliers is to pay the full DRG rate plus an additional payment for services provided.

The type of care that provides palliative services for terminally ill patients is known as:

Per diem is a type of reimbursement that pays a fixed rate per day for all services provided by a hospital.

If the patient requires an operation, the physician who conducts the operation is referred to as the ________.

Match the following -Code that establishes the level of urgency for admission

What is the Diagnosis Related Group (DRG) system?

Comorbidity may affect payment if the condition causes an increase in hospital length of stay by at least 2 days in approximately 50% of cases.

What is the role of an attending physician?

The UB-04 claim form is required by all private payers and is accepted by the Centers for Medicare and Medicaid Services (CMS).

When referring to DRGs, the abbreviation CC is used to indicate:

What types of institutional facilities use the UB-04 claim form?

Software that is used to calculate the DRG payment group is called a(n):

The computerized comprehensive list of codes for all services and items provided to hospital patients is known as the ________.

OPPS stands for:

What information is included in a charge description master (CDM)?

A code that describes an accident or mishap responsible for the patient's admission to the hospital is known as a(n):

The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters