CPT CODING AUDIT

Revenue Cycle and Collections Instructions The revenue cycle and the phases of the life cycle of patient accounts and collections. select and answer one of the following questions: 1. What are the steps in the revenue cycle? 2. Discuss the collection process 3. Describe the statements, dunning notices, and rules regarding the collection process.

Define a "new patient" according to the CPT manual.

Calculate the total charge, allowed amount, write-off, patient responsibility, and carrier responsibility for each of the following situations. Use the following table for your calculations. CPT Code Provider’s Charge Allowed Amount 99212 $66.00 $54.00 93040 $44.00 $36.00 99201 $88.00 $62.00 99204 $108.00 $75.00 97032 $45.00 $29.00 97110 $45.00 $29.00 99213 $90.00 $52.00 73630 $88.00 $$72.00 Patient 2 is charged 99204, 99213 and 97032. Deductible of $70 applies. Total charge. ____________________________________________________________ Allowed amount. ____________________________________________________________ Write-off. ____________________________________________________________ Patient responsibility. ____________________________________________________________ Carrier responsibility. ____________________________________________________________

QUESTION 10 With a DRG, Medicare pays for a hospitalization based on _____.     how long the patient was hospitalized     the diagnosis the patient was hospitalized to treat     how much the hospital did to treat the patient     how much the hospital spent caring for the patient.

question 7. Fill in the blank. The following table contains select data concerning several outpatient clinics in a new ambulatory care center at Hope University Hospital. Fill in the missing information

Select 3 of the following EDI transactions that are processed in the format established by the Health Insurance Portability and Accountability Act (HIPAA) A Order management B Eligibility C Release of Information D Consent forms E Claims status F Payment and remittance advice

Insurance Rejection Scenarios Scenario 1 A patient brings in a prescription for Singulair 10 mg for the pharmacy to fill, and decides to wait for their prescription. After obtaining all of the patients PHI and entering all the data into the computers, the technician proceeds to enter the prescription and adjudicate a claim to the patients insurance. Upon submission, the technician receives a rejection message stating that the patients is over the age of 18 and the insurance formulary requires a prior authorization. (Certain insurance companies will only cover Singulair for adults if doctors diagnose the patient with a specific diagnosis, such as Asthma) a. What steps need to be taken to begin the process of resolving the rejection? b. Who do you need to contact or notify, who completes the notification, and how are the individuals notified? c. What other options might be given and to whom? d. How long should this process take, on average? Scenario 2 A patient brings in a prescription…

Need  help in feeling out the chart. Thank you

Objective 4 - Explain how ABC can be simplified.The Bienestar Cardiology Clinic has two major activities: diagnostic andtreatment. The two activities use four resources: nursing, medical technicians,cardiologists, and equipment. Detailed interviews have provided the workdistribution matrix shown Activity      Nursing    Technicians  Cardiologists   Equipmnt  Total activity time Diagnostic    0,7            0,8                0,4               0,6             12.000 hours Treating       0,3             0,2                0,6               0,4              8.000 hours Total time    4.000        4.000            6.000           6.000           20.000 hours Cost            80.000      80.000           320.000      320.000   The total time estimated corresponds to practical capacity (interviewersadjusted the total time to about 80 percent of the available time). Theequipment time is measured in machine hours. Thus, the total time (atpractical capacity) in the system is 20,000 hours. In…

Objective 4 - Explain how ABC can be simplified.The Bienestar Cardiology Clinic has two major activities: diagnostic andtreatment. The two activities use four resources: nursing, medical technicians,cardiologists, and equipment. Detailed interviews have provided the workdistribution matrix shown Activity      Nursing    Technicians  Cardiologists   Equipmnt  Total activity time Diagnostic    0,7            0,8                0,4               0,6             12.000 hours Treating       0,3             0,2                0,6               0,4              8.000 hours Total time    4.000        4.000            6.000           6.000           20.000 hours Cost            80.000      80.000           320.000      320.000   The total time estimated corresponds to practical capacity (interviewersadjusted the total time to about 80 percent of the available time). Theequipment time is measured in machine hours. Thus, the total time (atpractical capacity) in the system is 20,000 hours. In…

Answer to question 12 on practice exam see picture for question. Disregard the pink message

1. How can social media help a hospital manage the patient experience? 2. Briefly explain the difference between short-term and long-term assets.

Milestone #1 – Research Project Overview (Week Two) Introduction: Provide a brief overview of the research healthcare. Describe the topic you are focusing on and establish the rationale behind your choice. Use the model for introduction on page 111 in Creswell & Creswell.  Purpose: Describe the main topics that you will examine in the context of the survey. You do not need to discuss the specific survey questions here. Rather, focus on the broader topics and themes that you will address in the questionnaire. Creswell & Creswell (2023) discuss this in Chapter 6.

Match each of the numbered descriptions 1 through 7 with the term or phrase it best reflects. Indicate your answer by writing the letter A through G for the term or phrase in the blank provided. A. Ethics. B. Fraud triangleC. Prevention.

Need Assistance with post-closting trial balance

Please show all steps in handwriting. I have dyslexia

Presented below are the transactions of the Skin Clinique own by Dr. Ramirez . Prepare a JOURNAL ENTRY AND TRIAL BALANCE

The duties of an agent when filling out an application include all of the following EXCEPT:    A: Make sure all required signatures are collected    B: Help the insured make up creative answers to stretch the truth about a past health issue to get the best possible coverage    C: To have all parties on the application initial any and all changes    D: To make sure that the insured answers all questions to their best knowledge and belief

Give typing answer with explanation and conclusion to all parts Though limited, which of the following does Medicare cover? a. assisted living facility care b. continuing care retirement community services c. adult day care services d. home health care

Please help sir get the ans