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Healthcare Reimbursement Final Exam Fall 2023 with verified solutions

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Healthcare Reimbursement Final Exam Fall 2023 with verified solutions There are 3 parties in healthcare reimbursement. Who is the first party? Patient or guarantor Which type of reimbursement methodology is associated with the abbreviation "PMPM"? Capitated payment What is an example of a charge that usually would be reviewed by an HIM coder? Claim is failing due to potentially incomplete code, including missing modifiers. Which of the following coding systems was created for reporting procedures and services performed by physicians in clinical practice? CPT What impact does a hospital acquired condition have on a hospital's Medicare reimbursement? If a hospital acquired condition causes a case to be grouped to a higher paying DRG, Medicare will only reimburse for the lower paying DRG. In the healthcare insurance sector, what does UCR stand for? Usual Customary and Reasonable Which statement describes the per diem payment method? Fixed rate for each day a covered member is hospitalized Which discounted fee-for-service healthcare payment method does Medicare use to reimburse physicians? RBRVS Which type of RAC review combines data analysis and submission of medical records to the RAC? Semi-automated In the healthcare industry, what is the term for receiving compensation for healthcare services that were previously provided? Reimbursement To which of the following factors is health insurance status most closely linked? Employment What is the optimum chart completion window for revenue cycle purposes? Within the bill hold period Which of the following is the correct format for HCPCS Level II codes? A1234 In the United States, what is healthcare insuran

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7/9/2019 ATI fundamentals, ATI RN Fundamentals Proctored Focus Flashcards |
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ATI fundamentals, ATI RN doyin Fundamentals
Proctored Focus Flashcards | Quizlet.pdf |ATI
fundamentals, ATI RN Fundamentals Proctored Focus

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Terms in this set (106)

Always correct You've answered all of these correctly!



+1 Home safety: -remove items that could cause
Teaching an older the client to trip (rugs, cords,
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,7/9/2019 ATI fundamentals, ATI RN Fundamentals Proctored Focus Flashcards |
Quizlet
adult client about carpets)
home safety -place electrical/extension cords




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,7/9/2019 ATI fundamentals, ATI RN Fundamentals Proctored Focus Flashcards |
Quizlet
against a wall behind furniture
-monitor gait/balance, provide
aids PRN
-make sure steps/sidewalks are
in good condition
-grab bars near toilet, tub,
shower
-stool riser, toilet cushion
-nonskid bath mats/shower mats
-shower chair or bedside
commode PRN
-ensure adequate lighting
-water heater 120
-no smoking if on oxygen, cotton
stuff only, no heating oil or nail
polish remover
-cook meat and fish fully,
handle properly



+1 Safe Medication
-assess client
Administration &
-inform charge nurse
Error
-complete incident report
Reduction:
Appropriate
Actions Following
a Medication Error


No Answers Yet You still haven't studied these!


Normal level 4,500 - 11,000
for WBC's



Normal lab values 13.5-17.5 g/dL
for Hbg male



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, 7/9/2019 ATI fundamentals, ATI RN Fundamentals Proctored Focus Flashcards |
Quizlet
Normal lab values 12-16 g/dL
for Hbg female



Normal lab values 135-145 mEq/L
for Na



Normal lab values 3.5-5 mEq/L
for K



Normal lab values 95-105 mEq/L
for Cl



Normal lab values 22-29 mEq/L
for HCO3



Normal BUN 7-18 mg/dL
lab values



Normal Creatine 0.6- 1.2 mg/dL
lab values



Normal 70-110 mg/dL
Glucose lab
values



Normal Calcium 8.5-10.5 mg/dL
lab values



Normal total 6-8 g/dL
protein lab values


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