Term
| form signed by patients that include procedures done and date of service |
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Definition
| Insurance or financial waivers |
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Term
| An ________________ is an alterting notice required for Medicare beneficiaries to help patients understand that all of their health care may not be covered services and advise regarding out of pocket expenses |
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Definition
| Advance beneficiary notice (ABN) |
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Term
| Describe the current and anticipated Medicare payment models |
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Definition
| It's a currently a fee for service payment system where providers are paid for the procedures carried out. Eventually it will be a pay for performance model which is based on reporting successful outcomes measures, quality of care, and care coordination |
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Term
| What are 4 CPT code modifiers? |
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Definition
1. -22, increased procedural services. Ex: hearing test for a young child 92557-22
2. -52, indicates reduced services. Ex: use this modifier if only tested one ear 92557-52
3. -53, discontinue procedure. Ex: if patient got sick
4. -59, distinct procedural service. Ex: 92540 is for basic vestibular evaluation which is made up of 4 distinct tests. If only 3 of the tests were done then you would add this modifier. |
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Term
| use when item/service is excluded (ex: hearing aids), many third-party payers require Medicare to deny before they pay |
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Definition
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Term
| use with voluntary ABN (non-covered service such as routine annual hearing tests); patients signature on the voluntary ABN means they may need to pay for the test |
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Definition
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Term
| Develops standards & inspects hospitals; interested in quality improvement, risk management, & patient safety; Established standards, including standards for leadership, patient care, training, records, documentation, safety, and facility management |
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Definition
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Term
| Medicare regulations stipulate that only ___ hospitals can be reimbursed through the Medicare program |
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Definition
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Term
| Keep deceased patient records for __ years past the last date of service |
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Definition
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