Chapter 1 CPMA Exam Prep Questions and Answers 100% Solved

Chapter 1 CPMA Exam Prep Questions and Answers 100% Solved 12.1%# of improper Medicare Fee-For-Service claim payments, according to Federal Government. FFSFee-For-Service Prepayment ReviewReview of claims prior to payment. Prepayment reviews result in an initial determination. Postpayment ReviewReview of claims after payment. May result in either no change to the initial determination or a revised determination, indicating an underpayment or overpayment. UnderpaymentA payment a provider receives under the amount due for services furnished under the Medicare statute and regulations. OverpaymentA payment a provider receives over the amount due for services furnished under Medicare statutes and regulations 5 Common reasons for overpayment are:*Billing for excessive and subsequent payment of the same service or claim. *Duplicate submission and payment for same service or claim *Payment for excluded or Medically unnecessary services. *Payment for services in setting not appropriate to pt's needs or condition *Payment to an incorrect payee.