CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
1. Steps of Revenue Cycle Patient Registration &
Check in/ Clinical en-
counter/ Accurate Cod-
ing and Billing/
Claims Generation
and Transmit- tal/
Processing Payments/
Preparation and
Transmit- tal of Patient
Statements/ Collections
and Finalizing
Payments/ Denials,
Ap- peals & Refunds
2. Coding analysis involves analyzing the fi-
nancial impact of
proper vs. improper
coding pro- cedures
in practice
3. What type of codes reflect the accurate level of ICD-10
med- ical necessity that justfies each CPT and
HCPC level II code?
4. Why is it important to have accurate coding minimizes denials and re-
jections while
ensuring the practice
is reimbursed the full
amount
5. All electronic opportunities to verfy active patient 6. If the
in- surance and benefits should be utilized - patient
hours does not
before visit have
insurance,
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
has a lapse in coverage, or cannot pay service, 24-48 hours
protect the practice
Advance Beneficiary No-
tice
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
by having the patient sign a Notice or
No- tice of Non-coverage prior to being seen
7. Electronic Medical Record and Practice Insurance Verification Sys
Management
Systems that are certified by CMS and the Office of the tems (IVS). NOTE:
Once National Coordinator for Health Information Technol- activated they
will auto- ogy (ONC) require to have built in Verification matically ping
the insur-
Systems. ance company
8. IVS will come back to the Practice management Green - Verified and
sys- tem (PMS) will highlight the appointment
Ap- proved
as Green, Yellow, or Red. What does each color
mean? Yellow - There may
be a problem with
this insur- ance
Red - Insurance is not
ac- tive or out of
9. Most PMS systems have the ability to capture the network and do not
IVS information in an electronic footprint that participate
occurs in the system. The information is held as
a Virtual Envelope
10. Even if the practice does not use EHR or EHR is
not interfaced with the PMS, do they still have
the ability to access IVS system?
Yes
11. Most insurance denials are due to what three reasons? Incorrect patient
demo-
graphics
invalid insurance
informa- tion
ICD-10 code that is
miss- ing a seventh
character re- quired for
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
that condition
SOLVED
1. Steps of Revenue Cycle Patient Registration &
Check in/ Clinical en-
counter/ Accurate Cod-
ing and Billing/
Claims Generation
and Transmit- tal/
Processing Payments/
Preparation and
Transmit- tal of Patient
Statements/ Collections
and Finalizing
Payments/ Denials,
Ap- peals & Refunds
2. Coding analysis involves analyzing the fi-
nancial impact of
proper vs. improper
coding pro- cedures
in practice
3. What type of codes reflect the accurate level of ICD-10
med- ical necessity that justfies each CPT and
HCPC level II code?
4. Why is it important to have accurate coding minimizes denials and re-
jections while
ensuring the practice
is reimbursed the full
amount
5. All electronic opportunities to verfy active patient 6. If the
in- surance and benefits should be utilized - patient
hours does not
before visit have
insurance,
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
has a lapse in coverage, or cannot pay service, 24-48 hours
protect the practice
Advance Beneficiary No-
tice
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
by having the patient sign a Notice or
No- tice of Non-coverage prior to being seen
7. Electronic Medical Record and Practice Insurance Verification Sys
Management
Systems that are certified by CMS and the Office of the tems (IVS). NOTE:
Once National Coordinator for Health Information Technol- activated they
will auto- ogy (ONC) require to have built in Verification matically ping
the insur-
Systems. ance company
8. IVS will come back to the Practice management Green - Verified and
sys- tem (PMS) will highlight the appointment
Ap- proved
as Green, Yellow, or Red. What does each color
mean? Yellow - There may
be a problem with
this insur- ance
Red - Insurance is not
ac- tive or out of
9. Most PMS systems have the ability to capture the network and do not
IVS information in an electronic footprint that participate
occurs in the system. The information is held as
a Virtual Envelope
10. Even if the practice does not use EHR or EHR is
not interfaced with the PMS, do they still have
the ability to access IVS system?
Yes
11. Most insurance denials are due to what three reasons? Incorrect patient
demo-
graphics
invalid insurance
informa- tion
ICD-10 code that is
miss- ing a seventh
character re- quired for
, CMM FINAL STUDY GUIDE WITH 100% VERIFIED SOLUTIONS |
SOLVED
that condition
