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AP Chemistry Chapter 13 Flashcards

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8568768660componenteach of the substances in a solution0
8568768661solventnormally the component present in the greatest amount1
8568768662solutescomponents within solution that are in lesser amounts than others2
8568768663aqueous solutionssolutions that contain water as a solvent and a gas, liquid, or solid as the solute3
8568768664solvationinteractions between solute and solvent molecules4
8568768665hydrationinteractions between solute and solvent molecules (solvation) in which the solvent is water5
8568768666entropythermodynamic quantity that describes the degree of randomness or disorder of a system in a solution; formation of solution is favored by greater entropy6
8568768667miscibledescribes pairs of liquids that mix/dissolve in all proportions ex: acetone and water7
8568768668immiscibledescribes pairs of liquids that do not dissolve in one another8
8568768669dilutesolution with a relatively small concentration of solute; measures cnc qualitatively9
8568768670concentratedsolution with a relatively high concentration of solute; measures cnc qualitatively10
8568768671mass percentage(mass of solute/mass of solution) x 100%11
8568768672parts per million (ppm)mass or volume of solute/ mass or volume of solution x 1,000,000; used to describe solutes in extremely low concentration12
8568768673molarityThe number of moles of solute per liter of solution; depends on volume of total solution13
8568768674mole fractionThe ratio of the moles of solute in solution to the total number of moles of both solvent and solute14
8568768675molalitythe concentration of a solution expressed in moles of solute per kilogram of solvent; depends on mass of solvent15
8568768676colligative propertiesproperties that depend on the quantity (cnc) and not the type or quality of the solute particles16
8568768677nonvolatilesubstance that has no measurable vapor pressure17
8568768678volatilesubstance that exhibits a vapor pressure18
8568768679vapor pressurepressure exerted by a vapor when equilibrium is reached19
8568768680Raoult's lawlaw stating that the partial pressure exerted by solvent vapor above a solution (P(A)) equals the product of the mole fraction of the solvent in the solution (X(A)) times the vapor pressure of the pure solvent20
8568768681ideal solutionsolution that obeys Raoult's law; very few solutions obey this law21
8568768682molal boiling-point-elevation constantA constant characteristic of a particular solvent that gives the increase in boiling point as function of solution molality: ⌂Tb = K(b)m.22
8568768683molal freezing-point-depression constantA constant characteristic of a particular solvent that gives the decrease of freezing point as a function of solution molality: ⌂Tf = K(f)m23
8568768684semipermeablecharacteristic of certain materials that allow some molecules to pass through their network of tiny pores but not others; allow small solvent molecules like water to pass through but not larger solute molecules or ions24
8568768685osmosisnet movement of solvent molecules from the less concentrated solution into the more concentrated one25
8568768686osmotic pressurepressure required to prevent osmosis by pure solvent26
8568768687isotoniccharacteristic of two solutions of identical osmotic pressure are separated by a semipermeable surface27
8568768688hypotoniccharacteristic of a solution of lower osmotic pressure28
8568768689hypertoniccharacteristic of a solution of higher osmotic pressure; more concentrated with respect to the diluted solution29
8568768690colloidal dispersionsMixtures containing particles larger than normal solutes but small enough to remain suspended in the dispersing medium.30
8568768691colloidintermediate types of dispersions or suspensions in which dispersed particles are larger than typical molecules but smaller than separate components of the mixture influenced by gravity31
8568768692Tyndall effectthe scattering of light by colloidal particles because light can pass through the suspension32
8568768693hydrophiliccharacteristic of water-loving colloids33
8568768694hydrophobiccharacteristic of water-fearing colloids34
8568768695dissolutionthe process of dissolving35

Gravitational Force | Physics Mid Term Study Guide Flashcards

Vocabulary

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16310187634accelerationincrease in the rate or speed of something.0
16310187635acceleration due to gravityIf gravity is the only force acting on an object, then we find the object will accelerate at a rate of 9.8m/s2 down toward the center of the Earth (this is often rounded to 10m/s2).1
16310187636air resistanceair resistance, a type of friction, or fluid resistance, another type of friction or fluid2
16310187637distancean amount of space between two things or people.3
16310187638forcestrength or energy as an attribute of physical action or movemen4
16310187639gravitythe force that attracts a body toward the center of the earth, or toward any other physical body having mass.5
16310187640gravitation potential energyGravitational potential energy is energy an object possesses because of its position in a gravitational field.6
16310187641inverse-square relationshipinverse square of the distance between the object and the source of the force. The magnitude of light, sound, and gravity obey this law, as do other quantities.7
16310187642kinetic energyenergy that a body possesses by virtue of being in motion.8
16310187643massa coherent, typically large body of matter with no definite shape.9
16310187644Newton's Law of UniversalNewton's law of universal gravitation states that a particle attracts every other particle in the universe using a force that is directly proportional to the product of their masses and inversely proportional to the square of the distance between them. Newton's law of universal gravitati10
16310187645Gravitationmovement, or a tendency to move, toward a center of attractive force, as in the falling of bodies to the earth.11
16310187646normal forcenormal force F n {\displaystyle F_{n}\ } is the component, perpendicular to the surface (surface being a plane)12
16310187647Orbitthe curved path of a celestial object or spacecraft around a star, planet, or moon, especially a periodic elliptical revolution.13
16310187648potential energythe energy possessed by a body by virtue of its position relative to others, stresses within itself, electric charge, and other factors.14
16310187649weigthA measure of the force of gravity on an object15

Weight vs Mass | PreAP Physics Mid-Term Flashcards

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16310345448WEIGHTmeasured with a spring scale0
16310345449WEIGHTexpressed in newtons (N)1
16310345450WEIGHTmeasure of the gravitational force on an object2
16310345451WEIGHTvaries (changes with location)3
16310345452MASSmeasured with a balance4
16310345453MASSexpressed in grams (kilograms)5
16310345454MASSconstant (does not change with location)6
16310345455MASSmeasure of the amount of matter in an object7

Medical Billing and Coding Final Flashcards

Medical Billing and Coding Final study guide

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8544895637What is a rule of conduct established and enforced by an authority or governing body,such as the federal governmentLaw0
8544895638Another name for terminating care of a patient isD) withdrawing from a case1
8544895639A health-care professional who stops care without providing an equally qualified substitute can be charged withD) abandonment2
8544895640The appropriate way for a physician to terminate the care of a patient is toSend the patient a certified letter3
8544895641What is the document called in which a patient names someone to make decisions regarding medical care in the event he or she is unable to do so?durable power of attorney4
8544895642A written court order addressed to a specific person, requiring that person's presence in court at a specific time issubpoena5
8544895643A process in which the opposing sides choose a person outside the court system with special knowledge in the field, to hear and decide a dispute is a(n)arbitration6
8544895644At the end of a labor and delivery nurse's shift, a nurse leaves a woman in labor before the nurse's replacement arrives. What kind of negligence does this constitute?abandonment7
8544895645A surgical incision is reopened after a patient starts to show signs of internal bleeding. It is discovered that the surgeon did not complete closure of all severed capillaries at the operative site. This is an example ofmalpractice8
8544895646A legal document addressed to the patient's family and physicians stating what type of treatment the patient wishes or does not wish when terminally ill is an(n)living will9
8544895647A physician reports a case of acquired immunodeficiency syndrome(AIDS) to the state. This isthe physician's public duty10
8544895648Which of the following is the appropriate way for the medical assistant working in a physician's office to leave a message for patients at their place of employment?leave a message that the patient's doctor's office is calling11
8544895649is considered a standard of behavior and a concept of right and wrong, beyond the legal consideration.Ethics12
8544895650Which of the following created federal laws to protect health-care workers from health hazards on the jobOSHA13
8544895651are formed through the influence of the family, culture and society, and serve as a basis for ethical conduct.Moral values14
8544895652For two parties to enter into an agreement, or contract, it is essential that both are capable of understanding the terms and conditions. This is referred to ascontractual capacity15
8544895653Speaking in such a way as to negatively influence others against an individual is an example ofdefamation of character16
8544895654The promise of "miracle cures" is an example offraud17
8544895655An advantage of computers in that theyprocess information with great speed18
8544895656A guideline for releasing medical information is tohave the patient give a verbal consent19
8544895657Internal audits are doneon random records by medical staff20
8544895658One of the most important duties of a medical assistant is tofill out and maintain accurate and thorough patient records21
8544895659Important information about a patient's medical history and present condition is found in thepatient's chart22
8544895660Patient records are used forpatient education, evaluating the quality of treatment, and medical research.23
8544895661WHich of the following organizations reviews patient charts to monitor whether the care provided and fee charged met accepted standards?Joint Commission on Accreditation of Healthcare Organizations24
8544895662The appropriate way to speak to a patient who has a hearing impairment is tospeak slowly25
8544895663The appropriate way to address a patient isMrs. Jones26
8544895664A physician tries unsuccessfully to call a patient. The medical assistant shouldrecord and date the call in the patient record27
8544895665The best place to interview a patient isin a private room28
8544895666The type of documentation that provides an orderly series of steps for dealing with any medical case isSOAP29
8544895667Of the federal programs providing health care, the largest is, which provides health insurance for citizens aged 65 and otherMedicare30
8544895668The person whose name the insurance is carried under is called theSubscriber31
8544895669In most cases, the insurer pays an annual cost or___ for health -care insurance.premium32
8544895670A fixed dollar amount the subscriber must pay or "meet" each year before the insurer begins to cover expenses is thedeductible33
8544895671Some medical practices may require the subscriber to pay a small fee at the time of service.copayment34
8544895672In a typical medical practice, insurance claims are fileda few business days after the date of service35
8544895673The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would bedenied as a billing error because the treatment was not medically necessary based on the diagnosis36
8544895674An insurance claims department compares the fee the doctor charges with the benefits provided by the patient's health plan. This is called thereview for allowable benefits37
8544895675Which of the following is what the patient owes after the insurance company has paid?subscriber liability38
8544895676Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?liability39
8544895677Under Medicare Part B, patients are not permitted toenroll, because coverage is automatic40
8544895678A patient who has been hospitalized up to 90 days for each benefit period is covered underMedicare Part A41
8544895679A benefit period for Medicare begins the day a patient goes into the hospital and ends when that patient has not been hospitalized for ___ days6042
8544895680Which of the following is a characteristic of Medicaid?it is a health cost assistance program43
8544895681Patients under the age of 65 who are blind or widowed or who have serious long-term disabilities, such as chronic joint pain or _____, many also be entitled to Medicare.kidney failure44
8544895682Which of the following is included in Medicare benefits for respite careThe terminally ill patient is moved to a care facility for the respite45
8544895683An organizations that provides pain relief to terminally ill patients and supports these patients and their families is ahospice46
8544895684The amount Medicare pays the physician or health-care provider after the $100 annual deductible is met is80%47
8544895685Which of the following is included under Workers' Compensation insurance?Rehabilitation costs are covered to return an employee to work48
8544895686Medicare encourages all practices to file claims electronically becausethe process saves time49
8544895687A characteristic of health maintenance organizations(HMO) isphysicians with HMO contracts are often paid a capitated rate50
8544895688HMO copayments are often$10-$2051
8544895689A husband and wife are both employed and have work-sponsored insurance plans that cover each other and their three children. Which insurance plan is the primary payer?the insurance plan of the person whose birthday comes first in the calendar year52
8544895690Electronic media claims (EMC) includedata elements that are transmitted in a computer file53
8544895691An appropriate approach to maintaining patient confidentiality on the computer is tochange your password every 90 days54
8544895692Under a contracted or fixed prepayment called____, physicians are paid a fixed amount of money to provide needed care.capitation55
8544895693TRICARE and CHAMPVA coverfamilies of all military personnel.56
8544895694When entering data in medical billing programs, alwaysenter information using capital letters57
8544895695The determination of the amount of money paid by a third-party papyer for a procedure ispre-certification58
8544895696What is the approval for payment from a third-party requested prior to a procedure?pre-authorization59
8544895697When a physician agrees to accept assignment, this means the physicianwill accept the amount of money that Medicaid will pay as payment in full for the Medicaid covered service60
8544895698Eligibility for Medicaid isbased on the patient's reported income from the previous month61
8544895699Which of the following is part of the process for verifying workers' compensation coverage?obtaining the employer's approval to provide treatment62
8544895700What is the term for the 10-digit number identifying the physician's medical specialty?taxonomy code63
8544895701What are usual fees that are listed on the office's fee schedulefee charged to most of their patients most of the time under typical conditions64
8544895702Which of the following must be verbally discussed with the beneficiary to enable the beneficiary to consider options and make informed choices?ABN65
8544895703If providers submit a claim for a simple procedure when in fact a more complicated procedure was documented in the medical record,______may occurunderpayment66
8544895704Which of the following may occur when providers submit claims that do not meet Medicare's coding or medical neccessity policies?denial of claim67
8544895705The use of ICD-9 codes is mandated byHIPAA68
8544895706A patient's diagnosis as established by the physiciandescribes the primary condition for which the patient is receiving treatment69
8544895707ICD-9 codes are updatedyearly70
8544895708The Alphabetic Index is organized bythe condition71
8544895709When you encounter the word see in the Alphabetic Index, you know thatyou must look in another category72
8544895710The Tabular List is organized bythe part of the body involved73
8544895711In order to ensure reimbursement at the highest allowed level,CPT codes mustinclude numbers and modifiers that reflect the services performed74
8544895712___The____ codes are the most important of the CPT codesE/M75
8544895713___For reporting purposes, CPT considers a patient "new" if the patient has not received professional services within the past ___year(s)three76
8544895714When unbundling is done intentionally to receive more payment than is correct, the claim is likely to be consideredfraudulent77
8544895715The Health Care Common Procedure Coding System(HCPCS) was developed for use in coding services forMedicare patients78
8544895716Analysis of the connection between the diagnostic and the procedural information on a claim is calledcode linkage79
8544895717An act of deception used to take advantage of another person or entity is calledfraud80
8544895718A health-care provider who practices under false qualifications/credentials is guilty offraud81
8544895719To avoid the risk of fraud by discovering and correcting compliance problems, medical offices usually have a(n)compliance plan82
8544895720Which of the following ICD-9-CM conventions is used around synonyms, alternative workings, or explanations?| |83
8544895721Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?includes84
8544895722Which ICD-9-CM convention indicates that an entry is not classified as part of the preceding codeexcludes85
8544895723The ICD-9-CM convention code first underlying disease meansthe code may not be used as the first code86
8544895724What does the ICD-9-CM convention NEC indicatenot elsewhere classifiable87
8544895725When analyzing diagnoses and locating the correct ICD code, in which step of the five-step process do you record the diagnosis code on the insurance claimstep 588
8544895726In which step of the five-step process of analyzing and locating the correct ICD code do you locate the statement of the diagnosis in the patient's medical record?step 189
8544895727In step 3 of the five-step process of analyzing and locating the correct ICD code, you willlocate the code from the Alphabetic index in the ICD's Tabular index90
8544895728Step 4 of the five-step process of analyzing and locating the correct ICD involvesfinding the code that corresponds to the patient's specifie disease or condition91
8544895729Finding the code in the ICD's Alphabetic Index is which step of analyzing and locating the correct ICD?step 292
8544895730If a lab bills for a general health panel but fails to perform one of the tests, it is guilty of which of these fraudulent coding and billing practicesreporting services that were not performed93
8544895731When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patient's request, the provider has committed which of these fraudulent coding and billing practices?performing billing for procedures that are not related to the patient's condition94
8544895732Billing for an Evaluation and Management service when the only service provided was a simple injection is an example ofreporting services at a higher level than was carried out95
8544895733There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check codes in question?last year's CPT96
8544895734A plus sign (+) is used to indicateadd-on codes97
8544895735Modifiers to CPT indicatethat some special circumstance applies to the service98
8544895736National codes issued by CMS that cover many supplies and durable medical equipment areHCPCS Level II codes99
8544895737Inaccuracy of linking diagnostic codes and procedural codes will result in all of the following excepttimely processing of claims100
8544895738Which of these structures or substances in the skin helps prevent UV radiation from damaging deep structures of the skin?melanin101
8544895739An easy way to remember when an E code is required isif the diagnosis makes you ask "How did that happen?"102
8544895740The skin plays a role in regulating body temperature bydilating or constricting blood vessels in the skin103
8544895741Which of the following is mostly adipose tissue?subcutaneous layer104
8544895742Sweat glands are found in thedermis105
8544895743When the supply of oxygen in the blood is low, the skin looks rather pale orbluish106
8544895744The most deadly skin cancer ismelonoma107
8544895745The most common skin cancer isbasal cell carcinoma108
8544895746The first thing you should do when answering the telephone isidentify the medical office and yourself109
8544895747The appropriate way to deal with a caller who refuse to identify himself is tosuggest that he write a letter to the physician and mark it "Personal"110
8544895748The recommended procedure for handling billing inquiries is topull the patient's chart and billing information111
8544895749If a patient was overcharged for services, the appropriate procedure is toask the patient to wait for a corrected statement before sending payment112
8544895750If patient calls with a billing problem but, in fact the proper fee was charged, the best approach is tospeak to the physician before responding to the patient113
8544895751If a patient remains dissatisfied after discussing a bill,document all comments and relay the information to the physician114
8544895752A guideline for dealing with an angry caller is toassure the patient that you will do your best to correct the problem115
8544895753A guideline to follow when an attorney calls the office is torelease information only when the physician has authorized you to do so116
8544895754One of the most important telephone skills is saying words correctly, which is calledpronunciation117
8544895755Speaking clearly and distinctly to help the person you are speaking to understand you is calledenunciation118
8544895756The appropriate way to address a patient with a last name that is different to pronounce is toask the patient how to pronounce her name119
8544895757If you do not recognize the name of the patient calling the most appropriate response is"Have you been to this practice before?"120
8544895758If you put a caller on hold and determine it will be a long wait,offer to call back121
8544895759When a call with a patient is long or complicatedsummarize the details of the call to ensure understanding by both you and the patient122
8544895760When dealing with a caller who is nervous, upset, or angry,show empathy and an understanding of the caller's feelings123
8544895761Before placing an outgoing telephone call to a patient you shouldverify the correct phone number124
8544895762Fax machines in a medical officeshould be placed in a secure location125

Medical Billing and Coding ICD-9 and ICD-10 INTRO Flashcards

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9327688764ICD-93-5 characters0
9327688765ICD-9First character is numeric or alpha (E or V)1
9327688766ICD-9Characters 2-5 are numeric2
9327688767ICD-9Always at least 3 characters3
9327688768ICD-9Use of decimal after 3 characters4
9327688769ICD-103-7 characters5
9327688770ICD-10First character is alpha (all letters except U are used)6
9327688771ICD-102nd character is numeric Characters 3-7 are alpha or numeric7
9327688772ICD-10Alpha characters are not case sensitive8
9327688773ICD-10Use of decimal after 3 characters9
9327688774ICD- 10 Volume 1tabular list10
9327688775ICD- 10 Volume 2instruction module11
9327688776ICD- 10 Volume 3alphabetical list12
9327688777diagnostic statementThis contains the medical term describing the condition for which a patient is receiving care13
9327688778conventionsthat are typographic techniques that provide visual guidance for understanding information and help the coder select the right code14

Medical Billing Flashcards

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12617796649CauteryIs an instrument used for cauterizing0
12617798058Close off dateslist of dates for the year that show end of payment periods and when claims need to be submitted by.1
12617804477ConsultationThis is the process of formally consulting and discussing.2
12617824048Continuing carecare for an individual care of clients in their own home.3
12617825961Cosmetic surgeryreconstruction of the face and body.4
12617827642Counsellingassistance and guidance psychological and social problems5
12617829888CryotherapyExternal therapeutic application of cold6
12617832779Diagnostic codingclinical coding, coding translation to illness, disease and injuries.7
12617837439Differentail BillingNo referred patients/patients have to pay the specialist fee8
12617840376Duplicate submissionBilling MSP for the same thing. It may be for two or more visits in the same day or for multiple services performed at the same time under the same fee item.9
12617850019Explanatory codeMSP may reject or refuse payment on a submitted claim and the code accompanies the rejection and provides reason10
12617853575Fee codecodes used in MSP billing11
12617854947Form 11subsequent treatment and condition form12
12617856004Form 8initial/ first treatment form13
12617857098Local anestheticsAn anesthetic that affects a restricted area of the body14
12617860120No charge referralGp referral to specialist. Transmitted to MSP with other invoices.15
12617863781Non-referral patientspatients that have not been referred to a specialist - differential billing16
12617866178Plaster castCast used for broken bones17
12617866803reciprocal billingAll provinces have agreed to pay for insured services for residents (except Quebec)18
12617869333ReferralIf a patient needs another consult after 6 months.19
12617871912Remittance statementThis is a payment report of all processed and rejected claims.20
12617873087suture materialSuture thread.21
12617874344Third partyA person or party that is not involved in the patients care and treatment. ex. lawyer22
12617876345Tray feesFee claim for supplies used in procedures: mini, minor and major23
12617879516Incentive PaymentsPay for performance; motive for employees24
12617880645MSCMedical service commission payment schedule25
12617881546HTNHypertension; high blood pressure26
12617882631NADno abnormality discovered27
12617885273BCMABritish Columbia Medical Association28
12617885638CPXcomplete physical exam29
12617885639GPgeneral practitioner30
12617886150ICBCInsurance corporation of British Columbia31
12617893332ICDinternational classification of diseases32
12617893333MSPMedical Services Plan33
12617894594MVAmotor vehicle accident34
12617896219PHNpersonal health number; 10 digits35
12617898234WSBCWork Safe BC36
12617900123WSBC to knowcodes: fee codes, diagnostic codes, location of injury and nature of injury Fee: one for the visit and the form Submit by: 3 days37
12617905943MSPCodes: fee codes and diagnostic codes Fee: one for the visit submit by: 3 months38
12617910355What is the max time limit for submitting a new claim?90 days39

Medical Billing and Reimbursement Systems Flashcards

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11550451041The case-mix management system that utilizes information from the Minimum Data Set (MDS) in long term care settings is called A. Medicare Severity Diagnosis Related Groups (MS-DRGs) B. Resource Based Relative Value System (RBRVS) C. Resource Utilization Groups (RUGs) D. Ambulatory Patient Classifications (APCs)C0
11550459848The prospective payment system used to reimburse home health agencies for patients with Medicare utilizes data from the. A. MDS (Minimum Data Set) B. OASIS (Outcome and Assessment Information Set) C. UHDDS (Uniform Hospital Discharge Data Set) D. UACDS (Uniform Ambulatory Core Set)B1
11550474357Under APCs, the payment status indicator "N" means that payment A. is for ancillary services B. is for a clinic or an emergency visit. C. is discounted at 50% D. is packaged into the payment for other servicesD2
11550483609All of the following items are "packaged" under Medicare ASC payments, Except for A. implanted prosthetic devices B. medical supplies C. splints and casts D. brachytherapyD3
11550484475Under the RBRVS, each HCPCS/CPT code contains three components, each having assigned relative value units. These three components are A. geographic index, wage index, and cost of living index B. fee-for-service, per diem payment, and capitation. C. conversion factor, CMS weight, and hospital-specific rate. D. physician work, practice expense, and malpractice insurance expense.D4
11550498252The prospectice payment system used to reimburse hospitals for Medicare hospital outpatients is called A. APGs B. RBRVS C. APCs D. MS-DRGsC5
11550517253Medicare patient was seen by Dr. Zachary, who is a nonparticipating physician. 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 A. financially liable for the Medicare Fee Schedule amount B. financially liable for charges in excess of the Medicare Fee Schedule, up to a limit C. not financially liable for any amount D. financially liable for only the deductibleB6
11550530672The prospective payment system based on resource utilization groups (RUGs) is used for reimbursement ________ for patients with Medicare. A. freestanding ambulatory surgery centers B. hospital-based outpatients C. intermediate care facilities D. skilled nursing facilitiesD7
11550535922The _______ is a statement sent to the provider to explain payments made by third-party payers. A. remittance advice B. advance beneficiary notice C. attestation statement D. acknowledgment noticeA8
11550544991HIPAA administrative simplification provisions require all of the following code sets to be used EXCEPT A. ICD-10-CM B. CDT C. DSM D. CPTC9
11550551141The computer-to-computer transfer data between providers and third-party payers in data format agreed upon by both parties is called A. HIPAA (Health Insurance Portability and Accountability Act) B. electronic data interchange (EDI) C. health information exchange (HIE) D. health data exchange (HDE)B10
11550567121A computer software program that assigns appropriate MS-DRGs according to the information provided for each episode of care is called a(n) A. encoder B. case-mix analyzer C. grouper D. scrubberC11
11550582567The standard claim form used by hospitals to request reimbursement for inpatient and outpatient procedure performed or services provided is called the A. UB-04 B. CMS-1500 C. CMS-1491 D. CMS-1600A12
11550584815Under ASC PPS, when multiple procedures are performed during the same surgical session, a payment reduction is applied. The procedure in the highest level group is reimbursed at _____ and all remaining procedures are reimbursed at ______. A. 50%, 25% B. 100%, 50% C. 100%, 25% D. 100%, 75%B13
11550596952The _______ refers to a statement sent to the patient to show how much the provider billed, how much Medicare reimbursed the provider, and what the patient must pay the providerA14
11550602863Currently, which prospective payment system is used to determine the payment to the "physician" for physician services covered under Medicare Part B, such as outpatient surgery performed on a Medicare patient? A. MS-DRGs B. APCs C. RBRVS D. ASC PPSD15
11550615219Which of the following best describes the situation of a provider who agrees to accept assignment for Medicare Part B services? A. The provider reimbursed at 15% above the allowed charge. B. The provider is paid according to the Medicare Physician Fee Schedule (MPFS) plus 10% C. The provider is paid according to the balance between the MPFS amount and the total charges. D. The provider is a nonparticipating provider.C16
11550622223When the MS-DRG payment received by the hospital is lower than the actual charges for providing the inpatient services for a patient with Medicare, then the hospital A. makes profit B. can bill the patient for the difference. C. absorbs the loss. D. can bill Medicare for the difference.C17
11550630401Under ASC PPS, bilateral procedures are reimbursed at ____ of the payment rate for their group A. 50% B. 100% C. 200% D. 150%D18
11550647647The Health Insurance Portability and Accountability Act (HIPAA) requires the retention of health insurance claims and accounting records for a minimum of _____ years, unless state law specifies a longer period. A. six B. five C. seven D. tenA19
11550653277____ is knowingly making false statements or representation of material facts to obtain a benefit or payment for which no entitlement would otherwise exist. A. Fraud B. Whistle-blowing C. Abuse D. AssaultA20
11550654504These are assigned to every HCPCS/CPT code under the Medicare hospital outpatient prospective payment system to identify how the service or procedure described by the code would be paid. A. geographic practice cost indices B. major diagnostic categories C. minimum data set D. payment status indicatorD21
11550665670The term used to indicate that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care is A. appropriateness B. evidence based medicine C. benchmarking D. medical necessityD22
11550667224This law prohibits a physician from referring Medicare patients to clinical laboratory services where the doctor or a member of their family has a financial interest. A. the False Claims Act B. the Civil Monetary Penalties Act C. the Federal Antikickback Statute D. the Stark I LawD23
11550678357_____ are errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients. A. Misadventures B. Adverse preventable events. C. Never events or sentinel events D. Potential compensable eventsC24
11550680355When a provider, knowingly or unknowingly, uses practices that are inconsistent with accepted medical practice and that directly or indirectly result in unnecessary costs to the Medicare program, this is called A. fraud B. abuse C. unbundling D. hypercodingB25
11550685184What prospective payment system reimburses the provider according to prospectively determined rates for a 60-day episode of care? A. home health resource groups B. inpatient rehabilitation facility C. long-term care Medicare severity diagnosis-related groups D. the skilled nursing facility prospective payment systemA26
11550698738If the Medicare nonPAR approved payment amount is $128.00 for a proctoscopy, what is the total Medicare approved payment amount for a doctor who does not accept assignment, applying the limiting charge for this procedure? A. $140.80 B. $140.00 C. $192.00 D. $147.20D27
11550722881Under the inpatient prospective payment system (IPPS), there is a 3-day payment window (formerly referred to as the 72-hour rule). This rule requires that outpatient preadmissions services that are provided by a hospital up to three calendar days prior to a patient's inpatient admission be covered by the IPPS MS-DRG payment for A. diagnostic services B. therapeutic (or nondiagnostic) services whereby the inpatient principal diagnosis code (ICD-10-CM) exactly match the code used for preadmission services. C. therapeutic (or nondiagnostic) services whereby the inpatient principal diagnosis code (ICD-10-CM) does not match the code used for preadmission services. D. diagnostic services and therapeutic (or nondiagnostic) services whereby the inpatient principal diagnosis code (ICD-10-CM) exactly matches the code used for preadmission services28
11550775129This initiative was instituted by the goverment to eliminate fraud and abuse and recover overpayments, and involves the use of ________. Charts are audited to identify Medicare overpayments and underpayments. These entities are paid based on a percentage of money they identify and collect on behalf of the government. A. Clinical Data Abstraction Centers (CDAC) B. Quality Improvement Organizations (QIO) C. Medicare Code Editors (MCE) D. Recovery Audit Contractors (RAC)D29
11550780957When a patient is discharged from the inpatient rehabilitation facility and returns within three calendar days (prior to midnight on the third day) is called a(n) A. interrupted stay B. transfer C. per diem D. qualified dischargeA30
11550793814In a global payment methodology, which is sometimes applied to radiological and similar types of procedures that involve professional and technical components, all of the following are part of the "technical" components EXCEPT A. radiological equipements B. physician services C. radiological supplies D. radiologic techniciansB31
11550802889Changes is case-mix index (CMI) may be attributed to all of the following factors EXCEPT A. changes in medical staff composition B. changes in coding rules C. changes in services offered D. changes in coding productivityD32
11550804923This prospective payment system replaced the Medicare physician payment system of "customary, prevailing, and reasonable (CPR)" charges whereby physicians were reimbursed according to their historical record of the charge for the provision of each service. A. Medicare Physician Fee Schedule (MPFS) B. Medicare Severity-Diagnosis Related Groups (MS-DRGs) C. Global payment D. CapitationA33
11550821201CMS-identified "Hospital-Acquired Conditions" mean that when a particular diagnosis is not "present on admission," CMS determines it to be A. medically necessary B. reasonable preventable C. a valid comorbidity D. the principal diagnosisB34
11550826860This process involves the gathering of charge documents from all departments within the facility that have provided services to patients. The purpose is to make certain that all charges are coded and entered into the billing system. A. precertification B. insurance verification C. charge capturing D. revenue cycleC35
11550848545The Correct Coding Initiative (CCI) edits contain a listing of codes under two columns titled "comprehensive codes" and "component codes". According to the CCI edits, when a provider bills Medicare for a procedure that appears in both columns for the same beneficiary on the same date of service, A. code only the component code. B. do not code the component code C. code only the comprehensive code D code both the comprehensive code and the component code.C36
11550856937The following type of hospital is considered excluded when it applies for and receives a waiver from CMS. This means that the hospital does not participate in the inpatient prospective payment system (IPPS) A. rehabilitation hospital B. long-term care hospital C. psychiatric hospital D. cancer hospitalD37
11550863151These are financial protections to ensure that certain types of facilities (e.g., children's hospitals) recoup all of their losses due to the differences in their APC payments and the pre-APC payments. A. limiting charge B. indemnity insurance C. hold harmless D. pass throughC38
11550894547LCDs and NCDs are review policies that describe the circumstances of coverage for various types of medical treatment. They advise physicians which services Medicare considers reasonable and necessary and may indicate the need for an advance beneficiary notice. They are developed by the Centers for Medicare and Medicaid Services (CMS) and Medicare Administrative Contractors. LCD and NCD are acronyms that stands for A. local covered determinations and noncovered determinations. B. local coverage determinations and national coverage determinations C. list of covered decisions and noncovered decisions D. local contractor's decision and national contractor's decisions.B39

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