HIM 310 HIM310 WEEK 3 QUIZ SOLUTIONS - 2020.docx

HIM 310 HIM310 WEEK 3 QUIZ SOLUTIONS - 2020
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Ashford HIM 310 Week 3 Quiz Answers (2020)
The NCQA offers __________ that focus on the employers, health plans, patients, and consumers to allow them to
make informed healthcare decisions based on quality.
In a(n) __________ the HMO will directly employ the physicians and various other healthcare professionals to
provide healthcare services to its members.
_________ is a type of organization that provides healthcare services through a contractual arrangement between a
hospital or hospitals and a physician or multiple physicians.
A(n) __________ is a healthcare provider that furnishes coordinated healthcare services through a number of
affiliated medical facilities.
The __________ methodology can be applied to procedures that are associated with technical components. This is a
lump-sum payment that can be distributed among all the physicians who either performed the procedure or
interpreted the results of the procedure.
A ________________________ is a transfer that takes place between a hospital and a facility that is excluded from
IPPS.
During a stay in a rehabilitation facility, the patient must receive close medical attention and have at least
__________ face-to-face visits per week by a licensed physician with specialized training in rehabilitative medicine.
For an IRF to be excluded from the IPPS. the facility must serve an inpatient population and at least __________
percent of the patients require intensive rehabilitative services for medical conditions.
Published every federal working day, the __________ is the official journal of the U.S. government.
_________ covers all immunosuppressive drugs following a covered transplant
in an approved facility based on the Criteria for Medicare Coverage of Heart
Which of the following best describes the situation of a provider who agrees
to accept assignment for Medicare services?
Which type of insurance includes catastrophic coverage?
In which state are critical access hospitals exempt from participation in
the outpatient prospective payment system (OPPS) because they qualify for
payment under the Social Security Act?
Using the following data, answer the question
The ambulatory payment classification (APC) system is based on the categorization of _____ services.
Payment Status Indicator __________ is for blood and blood products.
An OPPS payment status indicator is assigned to every __________ code and this indicator identifies whether the
service identified by this code is paid under OPPS.
Payment status indicator __________ is for surgical procedures where multiple procedure reductions apply.
If a home health agency provides four visits or less in an episode, it will be paid a standardized per-visit payment
instead of an episode payment for a 60-day period that is referred to as a
In the home health prospective payment system, a resource group is called __________ instead of DRG.