HIIM 242 Study Guide
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HIIM 242 Study Guide
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25 Questions

1. Which required Medicare administrative contractors (previously called carriers and fiscal intermediaries), as agents of the federal government, to attempt the collection of overpayments?

2. Which insurance is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury?

3. What does the provider receive upon eligibility verification through the Medicaid eligibility verification system (MEVS)?

4. Which requires hospitals to provide the Medicare Outpatient Observation Notice (MOON) to Medicare patients who receive observation services as outpatients for more than 24 hours?

5. Common law is also known as...

6. Which legislation included in ARRA amended the Public Health Service Act to establish an Office of National Coordinator for Health Information Technology (ONC) within HHS to improve health care quality, safety, and efficiency?

7. The Payment Error Prevention Program (PEPP) required facilities to...

8. Which authorized the implementation of a per-discharge DRG long-term (acute) care hospital prospective payment system (LTCH PPS) for cost reporting periods beginning on or after October 1, 2002?

9. A revenue code consists of...

10. Confidentiality is the...

11. The ANSI ASC X12N 837 is a...

12. The Privacy Act of 1974 was implemented to protect the privacy of individuals identified in information systems maintained by...

13. Which reviews managed care plans and develops report cards to allow consumers to make informed decisions when selecting a plan?

14. Per diem is the term associated with...

15. Computer-to-computer transfer of data between providers and third-party payers is...

16. The day sheet is a(n)...

17. Medicare Supplementary Insurance (MSI) is designed to supplement Medicare benefits by...

18. Which occurs when someone uses another person's name and/or insurance information to obtain medical and/or surgical treatment, prescription drugs, or medical durable equipment?

19. A method of controlling health care costs by reviewing the necessity of care, length of stay, and discharge planning is called...

20. Which covers individuals who permanently reside outside the United States and provides for health care coverage during short-term and long-term travel?

21. Which is a registered nurse or physician assistant who assists primary care providers with preauthorizations and referrals?

22. A risk contract...

23. A claim that is pending is in...

24. The False Claims Act (FCA)...

25. Which is responsible for reviewing health care provided by managed care organizations?

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