Part B payment may be made for ancillary services if: The admission was disapproved as not reasonable and necessary (and waiver of liability payment was not made). The day (s) of the otherwise covered stay during which the services were provided was not reasonable and necessary (and no payment was made under waiver of liability).
On an inpatient bill, accommodations are described by the assignment of revenue codes. What claim form is used to bill inpatient facility charges including accommodations (room) and ancillary charges?
CBC, chest xray, and respiratory therapy Examples of patient care services that may be provided by ancilliary departments. 81 Number of fields the CMS-1450 (UB-04) form have, known as form locators (FL)
The medical coding specialist assigns codes from which codebooks for inpatient facility coding? Outpatient facilities are required to report ICD-10-PCS codes to receive reimbursement for the services rendered. The chargemaster is a healthcare provider's comprehensive price list of all supplies, services, and equipment usage fees for patient care.
The HMO Act of 1973 specified requirements that must be met for an HMO to receive federal qualification. For example, federally qualified HMOs must provide basic health care services and charge a community rate.
Emergency care must be provided when needed, so many plans waive the deductible and coinsurance. Preadmission testing would be impractical. The other 3 choices are proven cost reducers.
Members of an HMO can generally not use health care providers outside the organization. An HMO has employees, while a POS generally contracts with independent providers. HMOs are generally nonprofit, while POS plans are for-profit.
Facility billing and coding final review study guide by sflood04 includes 72 questions covering vocabulary, terms and more. Quizlet flashcards, activities and games help you improve your grades.
The ___ codes are seven characters in length, alpha or numeric, and they are not case sensitive. The first character is always alphabetic.
Procedure coding system used to report procedures, services and items for hospital outpatient services.
An accounts receivable report lists outstanding accounts on the basis of when the account was paid in full.
The flow of data begins when the patient reports tp the hospital for patient care services. What information is collected from the patient at the time of admission?