RHIA

RHIA practice questions, page 62 of 73, with answer review and explanations.

Question 306

All of following items are packaged under the Medicare outpatient prospective payment system, EXCEPT for

  1. recovery room.
  2. supplies.
  3. anesthesia.
  4. medical visits.

Question 307

Under the RBRVS, each HCPCS/CPT code contains 3 components, each having assigned relative value units. These 3 components are

  1. geographic index, wage index, and cost of living index.
  2. fee-for-service, per diem payment, and capitation.
  3. conversion factor, CMS weight, and hospital-specific rate.
  4. physician work, practice expense, and malpractice insurance expense.

Question 308

The prospective payment system to hospitals for Medicare hospital s outpatients is called ___ and became effective on _________

  1. APGs, October 1,2000.
  2. RBRVS, January 1,2000.
  3. APCs, August 1,2000.
  4. DRGs, October 1,1983.

Question 309

A patient was seen by Dr. Zachary. The charge for the office visit was $125. The Medicare beneficiary had already met his deductible. The Medicare fee schedule amount is $100. Dr. Zachary does not accept assignment. The office manager will apply a practice termed as "balance billing," which means that the patient is

  1. financially liable for the Medicare fee schedule amount.
  2. financially liable for charges in excess of the Medicare fee schedule.
  3. not financially liable for any amount.
  4. is financially liable for the entire charge for the office visit.

Question 310

The prospective payment system based upon resource utilization groups (RUGs) is used for reimbursement to ________________ for Medicare patients.

  1. freestanding ambulatory surgery centers
  2. hospital-based outpatients
  3. intermediate care facilities
  4. skilled nursing facilities