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Reference no: EM133314922

Questions

1. UCR charges is a method of evaluating providers' fees in which the third-party payer pays for fees that are ________ in that provider's practice, ________ in the community, and ________ for the situation:

a. Usual/customary/relevant

b. Unique/codeable/reasonable

c. Usual/claimable/reasonable

d. Usual/customary/reasonable

2. Which of the following is TRUE about HCPCS:

a. Collection of codes and descriptors used to represent healthcare procedures, supplies.

b. Divided into two code levels or groups.

c. Used to report physicians' services to Medicare for reimbursement.

d. All the above statements are true about HCPCS

3. __________ are used to list the individual charges for every element entailed in providing a service (for example, surgical supplies, surgical equipment, room and board, etc.)

CMS-1500

DRG

UB-04

Chargemaster

4. Home Maintenance Organizations (HMO)

a. Represent contractual agreement between healthcare providers and a self-insured employer or a health insurance carrier.

b. A prepaid voluntary health plan that provides healthcare services in return for the payment of a monthly membership premium.

c. Provide benefits to enrollees only when the enrollees receive healthcare services from network providers.

d. Subscribers are allowed to seek care from providers outside the network.

Reference no: EM133314922

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