C812 Healthcare Reimbursement
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Free C812 Healthcare Reimbursement Questions
- Admission order
- Clinical laboratory report
- ECG report
- Radiology report
Explanation
- Anti-kickback statute
- Balanced Budget Act of 1997
- False Claims Act
- Health Insurance Portability and Accountability Act of 1996
Explanation
- The claim will be automatically approved without review.
- The provider may face penalties and delayed reimbursement.
- The provider will receive a bonus for timely submission.
- The claim will be forwarded to the Department of Justice for criminal investigation.
Explanation
- Immediately terminate their employment
- Provide informal counseling to discuss the errors
- Place the employee on unpaid leave
- Submit a formal action plan without discussion
Explanation
- It may lead to delayed payment due to claim rejection.
- It will have no effect on reimbursement.
- It could result in an increase in reimbursement.
- It only affects the patient's medical record, not reimbursement.
Explanation
- Patient authorizes payment to be made directly to the provider
- Provider agrees to accept as payment in full the allowed charge from the fee schedule
- Balance billing is allowed on patient accounts, but at a limited rate
- Participating provider receives a fee-for-service reimbursement
Explanation
- Regular audits of billing practices
- Increasing the number of claims submitted
- Reducing patient documentation requirements
- Encouraging upcoding for higher reimbursement
Explanation
- Because the catheter placement is considered part of the procedure
- Because the infusion procedure is more complex
- Because of the NCCI edits that prevent duplicate payments
- Because outpatient services are not covered by Medicare
Explanation
- It allows for separate payments for each procedure.
- It combines the costs of multiple procedures into a single payment.
- It provides additional payments for complex cases.
- It reduces the overall payment for outpatient services.
Explanation
- Diagnoses
- Procedures
- Financial information
- Test results
Explanation
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