HSA 525 Midterm Exam Latest
Question 1
What are the two types of forms used for health services billing?
CMS 1500 and CMS 1450
UB 04
CMS 1100 and CMS 1450
UB-05 and UB-1450
Question 2
Describe how Medicaid payments to providers are limited by the federal government.
The payments to providers are not limited by the federal government but rather by state
agencies that have predetermind estimates.
The law requires that Medicaid payments to qualified hospitals, nursing facilities, ICF/MRs,
and clinics not exceed a reasonable estimate of the amount that Medicare would pay for
equivalent services in the aggregate within state-owned or operated, non-state-owned or
operated, and private facilities.
CMS reviews state payment methodologies and supporting documentation to ensure that the
state plan methodology may be audited and is comprehensively described and that payment
rates are economic, efficient, and sufficient to attract willing and qualified providers.
All of the statements are correct.
None of the statements are correct
Question 3
What is charge explosion?
When charges increase dramatically over a set period of time
When the set of charges is explained in line item fashion on a master bill
Question 1
What are the two types of forms used for health services billing?
CMS 1500 and CMS 1450
UB 04
CMS 1100 and CMS 1450
UB-05 and UB-1450
Question 2
Describe how Medicaid payments to providers are limited by the federal government.
The payments to providers are not limited by the federal government but rather by state
agencies that have predetermind estimates.
The law requires that Medicaid payments to qualified hospitals, nursing facilities, ICF/MRs,
and clinics not exceed a reasonable estimate of the amount that Medicare would pay for
equivalent services in the aggregate within state-owned or operated, non-state-owned or
operated, and private facilities.
CMS reviews state payment methodologies and supporting documentation to ensure that the
state plan methodology may be audited and is comprehensively described and that payment
rates are economic, efficient, and sufficient to attract willing and qualified providers.
All of the statements are correct.
None of the statements are correct
Question 3
What is charge explosion?
When charges increase dramatically over a set period of time
When the set of charges is explained in line item fashion on a master bill
