Which PPS provides a predetermined payment that depends on the patients principal diagnosis comorbidities complications and principal and secondary procedures?
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Chapter 9 Review Quiz:Question 1:Which PPS provides a predetermined payment that depends on the patient'sprincipal diagnosis, comorbidities, complications, and principal and secondary procedures?A.SNF PPSB.OPPSC.IPPSD. MPFS Show Question 2: The skilled nursing facility prospective payment system uses a _____ paymentmodel. Get answer to your question and much more Question 3:Which of the following legislated implementation of the long-term (acute) carehospital inpatient prospective payment system? Get answer to your question and much more Question 4:The Resource-Based Relative Value Scale (RBRVS) system is now referred to as the Get answer to your question and much more Question 5:Reimbursement rates based on the anticipated care needs of patients result inreduced risks to facilities and to payers. Health care facilities and payers determine anticipatedcare needs by reviewing types and/or categories of patients treated by a facility as part of__________ management.A. claimsB. chargemasterC.case-mixD. capitation 4.Which PPS provides a predeterminedpayment that depends on the patient’sprincipal diagnosis, comorbidities,complications, and principal and secondaryprocedures?a) OPPSb) IPPSc) MPFSd) SNF PPS 5.Resource utilization groups (RUGs) usea reimbursement methodology used by skillednursing facilities. Get answer to your question and much more 6.Which of the following legislatedimplementation of the long-term (acute)care hospital inpatient prospectivepayment system? Get answer to your question and much more 7.The Resource-Based Relative Value Scale(RBRVS) system is now known as theclinical laboratory fee schedule.long-term care prospective payment system.Medicare physician fee schedule.outpatient prospective payment system. 8.Reimbursement rates based on theanticipated care needs of patients result inreduced risks to facilities and to payers. Theprocess by which health care facilities andpayers determine anticipated care needs byreviewing types and/or categories of patientstreated by a facility is called its Get answer to your question and much more 9.Diagnosis-related groups are organized into mutually exclusivecategories called , which are loosely based on body systems.a.ambulatory payment classificationsb. major diagnostic categoriesc.Outcomes and Assessment Information Setsd. resource utilization groups Upload your study docs or become a Course Hero member to access this document Upload your study docs or become a Course Hero member to access this document End of preview. Want to read all 19 pages? Upload your study docs or become a Course Hero member to access this document Tags Centers for Medicare and Medicaid Services Recommended textbook solutions
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What are prospective cost based rates based on?Currently, PPS is based upon the site of care. Units of payment and payment adjustments may also result in different rates for similar patients depending upon where they are treated. This may influence providers to focus on patients with higher reimbursement rates.
Which is responsible for data elements reported on the UB 04?The UB-04 is maintained by NUBC, which is a voluntary and multidisciplinary committee that develops data elements for claims and claim-related transactions and is responsible for the design and printing of the current UB-04 form.
Which is the relative volume and types of diagnostic/therapeutic and inpatient bed services?Resource Intensity.
Refers to the relative volume and types of diagnostic, therapeutic, and bed services used in the management of a particular illness. When clinicians use the notion of case mix complexity, they typically are referring to one or more aspects of clinical complexity.
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